Acinic cell carcinoma of the sinonasal cavity with intracytoplasmic crystalloids

Sinonasal Acinic Cell Carcinoma: A Review of the National Cancer Database

BACKGROUND

Acinic cell carcinoma (ACC) is a salivary gland malignancy that rarely can involve the sinonasal cavity. There are limited outcomes data available to guide management.

OBJECTIVE

We sought to use the National Cancer Database (NCDB) to characterize treatment outcomes in sinonasal ACC.

METHODS

A retrospective analysis of the NCDB from 2004 to 2016 for patients with ACC involving the sinonasal cavity was conducted. Demographic, treatment, and survival information were obtained. Unadjusted Kaplan-Meier estimates, log-rank tests, and a multivariable Cox proportional hazard model were used to assess overall survival (OS).

RESULTS

A total of 28 patients were included in the analysis with an average age of 58.6 ± 15.5 years. Half the patients (n = 14, 50%) were male, mostly white (n = 23, 82.1%), and with private insurance (n = 16, 57.1%). The nasal cavity was the most common subsite (n = 18, 64.3%), followed by the maxillary sinus (n = 5, 17.9%). Most patient received surgery alone (n = 17, 60.7%), with the remaining patients undergoing surgery followed by radiation (n = 8, 28.6%), radiation alone (n = 1, 3.6%), and no treatment (n = 2, 7.1%). The 1-, 5-, and 10-year survival in this cohort was 100% (95% CI: 100%-100%), 84.3% (95% CI: 71.2%-99.7%), and 72.2% (95% CI: 55%-94.8%), respectively. On multivariate analysis, older age was associated with worse OS (hazard ratio (HR): 1.27; 95% CI: 1.11-1.46, P < .001). Disease of the sphenoid sinus correlated with worse survival (HR: 198, 95% CI: 10.4-3,739, P < .001) and large tumor size was associated with worse OS on log-rank test, but not on multivariate analysis.

CONCLUSION

Sinonasal ACC is a rare entity with relatively good long-term outcomes. Older age and primary disease of the sphenoid sinus are associated with worse outcomes. Most patients are treated with surgical resection. Future research is needed to assess the optimal timing and indications for radiation therapy.

Acinic Cell Carcinoma of the Nasal Lateral Wall

Primary acinic cell carcinoma arising in the nose is exceptionally rare. In this report, we present a unique case of an acinic cell carcinoma of the nasal lateral wall, and it is only the second such case to be reported. We also engage in a systematic review of all 18 cases of acinic cell carcinoma of the nose reported in the literature in English so far.

Case-control analysis of survival outcomes in sinonasal acinic cell carcinoma

BACKGROUND

Acinic cell carcinoma (AciCC) is an uncommon malignant-epithelial salivary gland cancer. In very rare cases, this tumor may arise from sinonasal subsites, with only 19 cases described in the English-language literature.

METHODS

We performed a retrospective analysis of 18 cases of AciCC, obtained from searching the Surveillance, Epidemiology, and End Results (SEER) database between 1973 and 2009.

RESULTS

Patient demographics, including age, gender, and race, were similar to AciCC cases found in more common locations. However, all patients had low-grade tumors without regional or distant metastases. Comparing these patients to a stage, grade, and treatment-matched cohort of parotid AciCC, we found a lower 10-year overall survival (52.3%) with no significant difference in disease-specific survival (88.9%). Our meta-analysis of survival from cases in the literature estimated 10-year recurrence-free survival at 92.9%.

CONCLUSION

To our knowledge, this is the largest cohort of patients with AciCC reported in the English-language literature. Our results suggest that patients with sinonasal AciCC have excellent disease-specific survival, comparable to matched patients with AciCC in more common salivary gland subsites.

[Acinic cell carcinoma of the nasal septum]

INTRODUCTION

Nasal cavity acinic carcinoma are exceptional and often of turbinal origin. We report a case of acinic carcinoma of septal origin and discuss this histological type rare in this site.

OBSERVATION

A 47-year-old women, with no pathologic history, consulted for right nasal obstruction and hyposmia having evolved for a year. The clinical examination revealed a right nasal cavity lesion adhesive to the septum. Tomodensitometry showed a right nasal cavity and ethmoid opacity without bone destruction. The surgical treatment was endonasal tumor resection. The histological examination revealed a nasal fossa acinic carcinoma completely resected. A postoperative radiotherapy was initiated. The evolution was uneventful without recurrence after 4 years of follow-up.

DISCUSSION

Acinic carcinoma is rarely located in the nasal cavity. Its septal origin is exceptional. It is usually located at the salivary gland level. Curative treatment is surgery associated or not to radiotherapy. The prognosis is related to tumor extension and quality of resection.

Sinonasal acinic cell carcinoma: a clinicopathologic study of four cases

BACKGROUND

Acinic cell carcinoma is a low-grade malignant epithelial salivary gland neoplasm with a predilection for the parotid gland. To date, only 11 cases of sinonasal acinic cell carcinomas have been reported in the English-language literature. We present the clinicopathologic features of four sinonasal acinic cell carcinomas.

METHODS

The demographic data and pathologic material of four patients with sinonasal acinic cell carcinoma identified from the files of the Department of Pathology at The University of Texas M. D. Anderson Cancer Center between 1984 and 2002 were reviewed.

RESULTS

The four patients were two men and two women, with an age range of 42 to 65 years (mean, 54 years). The patients were initially seen with unilateral nasal obstruction. Histologically, all tumors were composed of round to ovoid cells with clear and/or basophilic granular cytoplasm and round, hyperchromatic, small, eccentrically located nuclei. The growth pattern was lobular, solid, and follicular. Histochemically, periodic acid-Schiff diastase-resistant granules were demonstrated in all cases. All patients were treated surgically. In addition, one patient received postoperative radiation. All patients are alive and well, with follow-up from 4 to 17 years.

CONCLUSIONS

Sinonasal acinic cell carcinoma is a distinct low-grade carcinoma that can be distinguished from other neoplasms by light microscopy and histochemical staining methods. Pathologists and surgeons should be aware of the occurrence of this type of salivary gland neoplasm in the sinonasal tract.

Acinic cell carcinoma: an unusual cause of bronchial obstruction in a child

Primary acinic cell carcinomas of the lung are rare tumors, usually presenting in adulthood as parenchymal or endobronchial masses. These lesions are generally recognized by their morphological pattern and the presence of periodic acid-Schiff (PAS)-positive, diastase-resistant cytoplasmic granules. We describe a case of pri-mary acinic cell carcinoma of the bronchus in a 4-year-old girl. The tumor has the typical acinar structures:weakly PAS-positive, diastase-resistant cytoplasmic granules and intra-acinar laminated calcific structures. A lobectomy was done with a clear bronchial resection margin. The child is well with no evidence of recurrence or metastasis 2 years postresection.

Acinic cell carcinoma of maxillary sinus

Acinic cell carcinoma is a tumor that occurs most commonly in the parotid glands. We have experienced a rare case of acinic cell carcinoma of the left maxillary sinus. The patient was a 71-year-old female. She noticed her left nasal congestion and epiphora from left eye in April 1994. She had a history of left maxillary sinus surgery in February, 1972. Antrotomy was performed and histopathological examination of specimen from the maxillary sinus proved acinic cell carcinoma. The tumor was considered to be the recurrence 22 years after initial surgery, because it coincided with the surgical specimen of previous surgery. Radical resection of maxilla was performed for complete resection of tumor with palate reconstruction by left scapula and latissimus dorsi myocutaneous flap. No recurrence is observed for more than 4 years after surgery. Although this tumor is of low grade malignancy, complete resection with adequate surgical margin is advisable due to high incidence of this tumor to recur after long periods of time.