Irfan Hanya, Ben-Tarifite Yusuf, Mahmood Rana
Whittington Hospital Trust, Magdala Avenue, London, N19 5NF, England.
Oxford University Hospitals Trust, Headley Way, Headington, Oxford, OX3 9DU, England.
Radiol Case Rep. 2025 Jul 26;20(10):5148-5155. doi: 10.1016/j.radcr.2025.06.069. eCollection 2025 Oct.
Adenoid cystic carcinoma (ACC) is an indolent malignancy that frequently recurs and particularly involves surrounding nerves which complicates management. ACC is mostly reported in the head-and-neck, but can also arise in the pelvis where treatment strategies are less established due to its rarity. In this case report a 44-year-old patient with previously treated vulval ACC presented with an isolated recurrence along the dorsal branch of the pudendal nerve. The pudendal nerve was successfully treated with salvage stereotactic ablative radiotherapy (SABR), with no evidence of active disease at 1-year follow-up. There is a potential role for SABR as an effective treatment for recurrent ACC with perineural spread, particularly when surgical options are limited. This case highlights the necessity of individualized treatment planning in rare anatomical presentations of ACC, with consideration for balancing oncological control with aim to preserve function. This report contributes to the limited literature on vulvar ACC and supports the integration of adjuvant radiotherapy into the multidisciplinary management.
腺样囊性癌（ACC）是一种生长缓慢的恶性肿瘤，常复发，尤其易侵犯周围神经，这使得治疗变得复杂。ACC大多发生于头颈部，但也可发生于盆腔，由于其罕见性，盆腔ACC的治疗策略尚不明确。在本病例报告中，一名44岁曾接受过治疗的外阴ACC患者出现沿阴部神经背支的孤立性复发。阴部神经通过挽救性立体定向消融放疗（SABR）成功治疗，1年随访时无疾病活动迹象。SABR作为一种有效治疗方法，在伴有神经周围扩散的复发性ACC中具有潜在作用，尤其是在手术选择有限时。本病例突出了在ACC罕见解剖表现中进行个体化治疗规划的必要性，同时要考虑在控制肿瘤的同时平衡保留功能的目标。本报告为外阴ACC的有限文献做出了贡献，并支持将辅助放疗纳入多学科管理。
