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Jian T, Yang M, Wu T, Ji X, Xia S, Sun F. Diagnostic value of dynamic contrast enhancement combined with conventional MRI in differentiating benign and malignant lacrimal gland epithelial tumours. Clin Radiol 2024; 79:e345-e352. [PMID: 37953093 DOI: 10.1016/j.crad.2023.10.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Revised: 10/13/2023] [Accepted: 10/16/2023] [Indexed: 11/14/2023]
Abstract
AIM To establish the diagnostic value of the quantitative parameters of dynamic contrast-enhanced (DCE) magnetic resonance imaging (MRI) combined with conventional MRI in differentiating of benign and malignant lacrimal gland epithelial tumours. MATERIALS AND METHODS A retrospective analysis of primary lacrimal gland epithelial tumours confirmed by histopathology was conducted. Conventional MRI features and DCE-MRI quantitative parameters were collected and subjected to analysis. The diagnostic value was evaluated using receiver operating characteristic (ROC) curve analysis. RESULTS A total of 53 patients were enrolled of which 29 had malignant, whereas 24 had benign tumours. Conventional MRI revealed statistically significant differences between benign and malignant tumours regarding maximum tumour diameter, posterior margin characteristic, bone destruction, and erosion. The Ktrans and Kep values obtained by DCE-MRI were higher in malignant than in benign tumours, with a statistically significant (p<0.001 and p=0.022). A type I time-signal intensity (TIC) curve was more frequent in benign tumours, whereas a type II TIC curve was prevalent in malignant tumours (p=0.001). ROC analysis showed that Ktrans had the best diagnostic value of the DCE-MRI parameters (area under the ROC curve [AUC] of 0.822, 75.9% sensitivity, and 83.3% specificity, p<0.001). The combination of conventional MRI and DCE-MRI factors had the best diagnostic value and balanced sensitivity and specificity (AUC of 0.948, 93.1% sensitivity, and 91.7% specificity, p<0.001). CONCLUSIONS The present findings indicate that the combination of quantitative parameters of DCE-MRI and image characteristics of conventional MRI have a high diagnostic value for the diagnosis of benign and malignant lacrimal gland epithelial tumours.
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Affiliation(s)
- T Jian
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China
| | - M Yang
- Department of Ophthalmology, Taizhou Hospital of Zhejiang Province affiliated to Wenzhou Medical University, Taizhou, China
| | - T Wu
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China
| | - X Ji
- Department of Radiology, Tianjin First Central Hospital, Tianjin, China
| | - S Xia
- Department of Radiology, Tianjin First Central Hospital, Tianjin, China
| | - F Sun
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China.
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2
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Malik M, Daniel C, Faulkner J, Uddin J, Arora A, Jeannon JP. Robotic assisted orbital surgery for resection of advanced periocular tumours - a case series report on the feasibility, safety and outcome. Eye (Lond) 2024:10.1038/s41433-024-02932-6. [PMID: 38388832 DOI: 10.1038/s41433-024-02932-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Revised: 12/18/2023] [Accepted: 01/12/2024] [Indexed: 02/24/2024] Open
Abstract
PURPOSE Orbital surgery benefits from well-designed instrumentation that offers gentle tissue manipulation, high manoeuvrability and control. Nevertheless, in confined spaces, tissue manipulation must be accomplished with exceptionally high accuracy and precision. This is where robotic surgery offers an advantage. We aimed to evaluate a robotic-assisted surgical system's feasibility, safety and outcome in assisting tumour clearance. PATIENTS AND METHODS A case series of patients with advanced periocular tumours undergoing robotic-assisted globe-sparing resection was performed using the DaVinci XI system (Intuitive Surgical, Inc). Institutional ethics and multidisciplinary approval were sought in all cases. RESULTS Four patients with advanced periocular tumours underwent robotic-assisted orbital surgery at a mean age of 63 years (range 42-86). Two patients were diagnosed with squamous cell carcinoma, and two had basal cell carcinoma. One patient was found to have positive lymph nodes at the time of surgery and underwent simultaneous parotidectomy and lymph node clearance. Clear resection of the primary tumour was achieved in all patients; three patients underwent further resection due to narrow margins prior to reconstruction. Patients were follow-up for at least one year, and three remained disease-free. One patient with pre-existing extra-orbital disease developed metastatic disease four months post-op. All patients preserved vision peri-operatively, with no complaints of diplopia. Moderate ocular surface disease was noted in two patients. CONCLUSION Our series highlights the potential advantage of three-dimensional optics, multi-directional instrumentation and motion scaling technology to achieve globe-sparing tumour resection in advanced periocular tumours. However, further robotic instrumentation development is required for orbital surgery.
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Affiliation(s)
- Mohsan Malik
- Adnexal Service, Moorfields Eye Hospital, London, EC1V 2PD, UK
| | - Claire Daniel
- Adnexal Service, Moorfields Eye Hospital, London, EC1V 2PD, UK
| | - Jack Faulkner
- Head and Neck Oncology, Guys and St Thomas Hospital, London, SE1 9RT, UK
| | - Jimmy Uddin
- Adnexal Service, Moorfields Eye Hospital, London, EC1V 2PD, UK
| | - Asit Arora
- Head and Neck Oncology, Guys and St Thomas Hospital, London, SE1 9RT, UK
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3
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Goldberg H, Jiang X, Fan J, Zhao J, Ning J, Williams M, Frank S, Moreno A, Gunn B, Ferrarotto R, Esmaeli B. Lacrimal Gland Adenocarcinoma Clinicopathologic Features and Outcomes Compared With Those of Lacrimal Gland Adenoid Cystic Carcinoma. Ophthalmic Plast Reconstr Surg 2024:00002341-990000000-00333. [PMID: 38319188 DOI: 10.1097/iop.0000000000002606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2024]
Abstract
PURPOSE Lacrimal gland (LG) adenocarcinomas (ACs) are rare, with limited data. We compared clinicopathologic features and local recurrence, distant metastasis, and survival rates between LG AC and LG adenoid cystic carcinoma (ACC). METHODS The records of LG AC patients treated from 2008 to 2022 and LG ACC patients treated from 1998 to 2022 at the same center were retrospectively reviewed. RESULTS The study included 20 patients with AC; 10 de-novo AC, 10 ex-pleomorphic AC; and 51 ACC patients. The median age at diagnosis was 61 years for de-novo AC, 54 years for ex-pleomorphic AC, and 45 years for ACC. All groups had male predominance. The initial T category was T2 in 50% (5/10) of de-novo ACs; 60% (6/10) of ex-pleomorphic ACs; and 59% (30/51) of ACCs. Perineural invasion was present in 33% (5/15) of ACs and 90% (45/50) of ACCs (p < 0.001). Of the 20 AC patients, 14 had eye-sparing surgery; 4 had orbital exenteration; and 2 had unresectable disease. All AC patients received postoperative radiotherapy and 15 (75%) received concurrent chemotherapy. Fourteen AC patients were tested for human growth factor receptor 2 expression, and 10 (71%) were human growth factor receptor 2 positive; 5 received human growth factor receptor 2-targeted therapy. AC and ACC had similar 5-year recurrence rates (20% and 33%, respectively, p = 0.31) and metastasis rates (20% and 34%, respectively, p = 0.30). de-novo AC, ex-pleomorphic AC, and ACC had similar 5-year disease-specific survival rates (80%, 79%, and 81%, respectively, p > 0.99). CONCLUSIONS LG AC and ACC have similar baseline clinicopathologic features, except that perineural invasion is more common in ACC, and similar recurrence, metastasis, and survival rates. Human growth factor receptor 2-targeted therapy may be appropriate in some patients with LG AC.
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Affiliation(s)
- Hila Goldberg
- Orbital Oncology & Ophthalmic Plastic Surgery, Department of Plastic Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas, U.S.A
| | - Xinyang Jiang
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, Texas, U.S.A
| | - Janet Fan
- Orbital Oncology & Ophthalmic Plastic Surgery, Department of Plastic Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas, U.S.A
| | - Jiawei Zhao
- Orbital Oncology & Ophthalmic Plastic Surgery, Department of Plastic Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas, U.S.A
| | - Jing Ning
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, Texas, U.S.A
| | - Michelle Williams
- Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, Texas, U.S.A
| | - Steven Frank
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, U.S.A
| | - Amy Moreno
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, U.S.A
| | - Brandon Gunn
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, U.S.A
| | - Renata Ferrarotto
- Department of Thoracic/Head and Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, U.S.A
| | - Bita Esmaeli
- Orbital Oncology & Ophthalmic Plastic Surgery, Department of Plastic Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas, U.S.A
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4
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He L, Zhang J, Zhu T, Zhao P, Mou P, Tang S. Incidence, clinical features, and survival outcomes of primary malignant lacrimal gland tumors: A population-based analysis. Cancer Med 2024; 13:e6831. [PMID: 38230983 PMCID: PMC10905223 DOI: 10.1002/cam4.6831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 11/29/2023] [Accepted: 12/08/2023] [Indexed: 01/18/2024] Open
Abstract
BACKGROUND Studies on the epidemiological information and prognosis of primary malignant lacrimal gland tumors (MLGTs) are rare for its low occurrence. The goal of our research was to investigate the epidemiological characteristics and survival outcomes of patients with MLGTs. METHODS Incidence and demographic information of patients with MLGTs were collected from the Surveillance, Epidemiology, and End Results (SEER) database. To identify independent prognostic factors for disease-specific survival (DSS) and overall survival (OS), univariate and multivariate Cox regression analysis were performed. RESULTS The overall incidence of primary MLGTs from 1975 to 2020 was 0.413/1,000,000 (according to the 2000 American standard population), with a steadily increasing incidence over years. A total of 964 patients with primary MLGTs were diagnosed, with an average age of 59.3 years. Of these, 53.2% were aged ≥60 years, 57.4% were female, and 77.1% were whites. Multivariate Cox regression analysis demonstrated that year of diagnosis, age, sex, histological type, SEER stage, surgery, and chemotherapy were independent prognostic factors of DSS or OS. CONCLUSIONS Although primary MLGT is rare, its incidence has steadily increased in the past 46 years, and surgery was related to a better prognosis.
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Affiliation(s)
- Lin‐feng He
- Department of OphthalmologyChangzheng Hospital, Second Affiliated Hospital of Naval Medical UniversityShanghaiChina
| | - Jin‐di Zhang
- Department of OphthalmologyChangzheng Hospital, Second Affiliated Hospital of Naval Medical UniversityShanghaiChina
| | - Teng‐fei Zhu
- Department of AnesthesiologyChangzheng Hospital, Second Affiliated Hospital of Naval Medical UniversityShanghaiChina
| | - Peng‐cheng Zhao
- Department of AnesthesiologyShanghai Ninth People's Hospital, Shanghai Jiao Tong University School of MedicineShanghaiChina
| | - Pei Mou
- Department of OphthalmologyChangzheng Hospital, Second Affiliated Hospital of Naval Medical UniversityShanghaiChina
| | - Shi‐yi Tang
- Department of OphthalmologyGongli Hospital of Shanghai Pudong New AreaShanghaiChina
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5
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Schellini SA, Santos Souza D, Almeida AAMP, Schellini RA, Ferraz LCB. Primary lacrimal gland sebaceous carcinoma - case presentation and literature review. Orbit 2023:1-6. [PMID: 38100406 DOI: 10.1080/01676830.2023.2291059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Accepted: 11/29/2023] [Indexed: 12/17/2023]
Abstract
Primary sebaceous carcinoma of the lacrimal gland (PSCLG) is the rarest lacrimal gland (LG) tumor, often belatedly diagnosed, worsening the prognosis. We present a 68-year-old man with a large, indurated mass in the left orbital outer quadrant, visible at the conjunctival upper temporal fornix, extending to the lower fornix, with left gaze restriction. The lesion was not related to the eyelid or other periocular tissues. Excisional biopsy revealed the PSCLG diagnosis. There are only eight others previous PSCLGs. Males are the most affected. Indurated mass in the lacrimal fossa, with eyelid in "S" shape is the most common presentation. Image exams are suggestive, but histological and immunohistochemical evaluations showing a single tumor cell line within LG are mandatory for definitive diagnosis. Larger and more extensive lesions can have a poor prognosis, but early detection can favor the outcome.
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Affiliation(s)
- Silvana A Schellini
- Ophthalmology Department, Botucatu Medical School, State University of Sao Paulo, Botucatu, Brazil
| | - Daniela Santos Souza
- Pathology Department, Botucatu Medical School, State University of Sao Paulo, Botucatu, Brazil
| | - Amanda A M P Almeida
- Ophthalmology Department, Botucatu Medical School, State University of Sao Paulo, Botucatu, Brazil
| | - Rodolfo A Schellini
- Radiology Department, Botucatu Medical School, State University of Sao Paulo, Botucatu, Brazil
| | - Lucieni C B Ferraz
- Ophthalmology Division, State Hospital of Bauru, State of Sao Paulo, Bauru, Brazil
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Fattahi MR, Zarafshani M, Abdolahad M, Jalaeefar A, Mahdavi R, Yousefpour N, Saffar H, Mousavi‐Kiasary SMS, Pakdel F. Intraoperative use of electrical impedance spectroscopy for adenoid cystic carcinoma of the lacrimal gland: A case report. Clin Case Rep 2023; 11:e7995. [PMID: 37822486 PMCID: PMC10562655 DOI: 10.1002/ccr3.7995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Revised: 09/01/2023] [Accepted: 09/18/2023] [Indexed: 10/13/2023] Open
Abstract
Key Clinical Message Electrical Impedimetric Tumor Detection System is a novel and promising tool for fast intraoperative tumor delineation and accurate safe margin detection in orbital tumors. Abstract Adenoid cystic carcinoma (ACC) is a rare malignant tumor of epithelial origin, typically arising from the salivary and lacrimal glands. ACC is notorious for recurrence and a high rate of morbidity and mortality despite therapy. We presented a 48-year-old male patient with lacrimal gland ACC of the right orbit who underwent radical tumor resection and adjuvant radiotherapy. We applied a new diagnostic method, the Electrical Impedimetric Tumor Detection System, during surgery and tested its performance to enhance the precision of tumor resection. Two months after surgery, he underwent external radiation of 58 Gy in 29 fractions. He showed no tumor recurrence or metastasis in the 1-year follow-up visits. ITDS showed a precision of tumor and margin detection consistent with histopathology results. This novel ITDS may be a reliable system for fast intraoperative tumor delineation and accurate, safe margin detection in orbital tumors.
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Affiliation(s)
- Mohammad Reza Fattahi
- Student Research Committee, School of Advanced Technologies in MedicineShahid Beheshti University of Medical SciencesTehranIran
- Department of Surgical Oncology, Cancer InstituteTehran University of Medical SciencesTehranIran
- UT and TUMS Cancer Electronics Research CenterTehran University of Medical SciencesTehranIran
| | - Mohammadkian Zarafshani
- Department of Surgical Oncology, Cancer InstituteTehran University of Medical SciencesTehranIran
- Cancer Biology Research Center, Cancer InstituteTehran University of Medical SciencesTehranIran
| | - Mohammad Abdolahad
- Department of Surgical Oncology, Cancer InstituteTehran University of Medical SciencesTehranIran
- UT and TUMS Cancer Electronics Research CenterTehran University of Medical SciencesTehranIran
- Nano Electronic Center of Excellence, Nano‐bioelectronic Devices Lab, Cancer Electronics Research Group, School of Electrical and Computer Engineering, College of EngineeringUniversity of TehranTehranIran
| | - Amirmohsen Jalaeefar
- Department of Surgical Oncology, Cancer InstituteTehran University of Medical SciencesTehranIran
| | - Reihane Mahdavi
- Nano Electronic Center of Excellence, Nano‐bioelectronic Devices Lab, Cancer Electronics Research Group, School of Electrical and Computer Engineering, College of EngineeringUniversity of TehranTehranIran
| | - Narges Yousefpour
- Nano Electronic Center of Excellence, Nano‐bioelectronic Devices Lab, Cancer Electronics Research Group, School of Electrical and Computer Engineering, College of EngineeringUniversity of TehranTehranIran
| | - Hana Saffar
- Department of Pathology, Imam Khomeini Hospital Center, Cancer InstituteTehran University of Medical SciencesTehranIran
| | - Seyed Mohamad Sadegh Mousavi‐Kiasary
- Nano Electronic Center of Excellence, Nano‐bioelectronic Devices Lab, Cancer Electronics Research Group, School of Electrical and Computer Engineering, College of EngineeringUniversity of TehranTehranIran
| | - Farzad Pakdel
- Department of Oculofacial Plastic Surgery, Farabi HospitalTehran University of Medical SciencesTehranIran
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7
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Karp JM, Gordon AJ, Hu K, Belinsky I, Jacobson A, Li Z, Persky M, Persky M, Givi B, Tam MM. Pathologic Features, Treatment, and Clinical Outcomes of Lacrimal Gland Cancer. Cureus 2023; 15:e44466. [PMID: 37791145 PMCID: PMC10544231 DOI: 10.7759/cureus.44466] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/31/2023] [Indexed: 10/05/2023] Open
Abstract
OBJECTIVES Lacrimal gland cancer is a rare malignancy with little data known about its pathologic characteristics or optimal management. We performed a large database analysis using the National Cancer Database (NCDB) to elucidate this unusual condition. METHODS Patients with lacrimal gland cancer diagnosed between 2004 and 2018 were included in the analysis. Using available clinical data, we excluded all patients with histologies likely reflective of lacrimal sac or duct cancer, which are coded similarly to lacrimal gland cancer in the NCDB. Kaplan-Meier analysis was used to estimate overall survival (OS), and Cox proportional hazards models were used to indicate covariates associated with survival. RESULTS A total of 440 cases of lacrimal gland cancer were included in the analysis, with a median follow-up of 52.9 months. The five-year OS for the entire cohort was 65.0%. Adenoid cystic carcinoma was the predominant histology (47.3%). Cox models showed that improved OS was associated with surgical resection (UVA: p < 0.001; MVA: p = 0.035). A detriment in OS was associated with increasing age, Charlson-Deyo score of 1, T4 stage, and positive margins and on UVA for adenocarcinoma and malignant mixed tumor histology. CONCLUSION Adenoid cystic carcinoma comprises the plurality of lacrimal gland cancers. About half of patients with lacrimal gland carcinoma will live beyond 10 years, underscoring the importance of reduced morbidity of treatment. Surgical management is associated with improved prognosis. Further study will elucidate the role of surgical excision and radiotherapy in lacrimal gland cancer.
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Affiliation(s)
- Jerome M Karp
- Radiation Oncology, New York University (NYU) Langone Health, New York, USA
| | - Alex J Gordon
- Otolaryngology - Head and Neck Surgery, University of Pennsylvania, Philadelphia, USA
| | - Kenneth Hu
- Radiation Oncology, New York University (NYU) Langone Health, New York, USA
| | - Irina Belinsky
- Ophthalmology, New York University (NYU) Langone Health, New York, USA
| | - Adam Jacobson
- Otolaryngology - Head and Neck Surgery, New York University (NYU) Langone Health, New York, USA
| | - Zujun Li
- Hematology and Medical Oncology, New York University (NYU) Langone Health, New York, USA
| | - Michael Persky
- Otolaryngology - Head and Neck Surgery, New York University (NYU) Langone Health, New York, USA
| | - Mark Persky
- Otolaryngology - Head and Neck Surgery, New York University (NYU) Langone Health, New York, USA
| | - Babak Givi
- Head and Neck Service, Memorial Sloan Kettering Cancer Center, New York, USA
| | - Moses M Tam
- Radiation Oncology, New York University (NYU) Langone Health, New York, USA
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8
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He LF, Mou P, Wei RL. Epidemiology and survival outcomes of patients with orbital region non-cutaneous squamous cell carcinoma: a population-based analysis. Front Oncol 2023; 13:1152337. [PMID: 37213302 PMCID: PMC10196690 DOI: 10.3389/fonc.2023.1152337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Accepted: 04/17/2023] [Indexed: 05/23/2023] Open
Abstract
Background Non-cutaneous squamous cell carcinoma (ncSCC) of the orbital region is very rare. Thus, its epidemiological characteristics and prognosis are poorly understood. The aim of the study was to assess the epidemiological characteristics and survival outcomes of ncSCC of the orbital region. Methods Incidence and demographic data on ncSCC of the orbital region were extracted from the Surveillance, Epidemiology, and End Results (SEER) database and analyzed. The chi-square test was used to calculate the differences between groups. Univariate and multivariate Cox regression analyses were performed to determine the independent prognostic factors for disease-specific survival (DSS) and overall survival (OS). Results The overall incidence of ncSCC in the orbital region from 1975 to 2019 was 0.68/1,000,000, and the incidence showed an increasing trend during this period. A total of 1,265 patients with ncSCC of the orbital region (mean age, 65.3 years) were identified in the SEER database. Of these, 65.1% were aged ≥60 years, 87.4% were White, and 73.5% were male. The conjunctiva (74.5%) was the most common primary site, followed by the orbit (12.1%), lacrimal apparatus (10.8%), and overlapping lesion of the eye and adnexa (2.7%). Multivariate Cox regression analysis revealed that age, primary site, SEER summary stage, and surgery were independent prognostic factors for DSS, whereas age, sex, marital status, primary site, SEER summary stage, and surgery were independent prognostic factors for OS. Conclusions The incidence of ncSCC in the orbital region has increased over the past 40 years. It usually affects White people, men, and people aged ≥60 years, and its most common site is the conjunctiva. Orbital SCC has worse survival outcomes than SCC of other sites in the orbital region. Surgery is the independent protective treatment for ncSCC of the orbital region.
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9
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Ashok Kumar P, Wang D, Huang D, Paulraj S, Sivapiragasam A. Current Trends in the Management of Epithelial Lacrimal Gland Tumors: A Retrospective National Cancer Database Analysis. Cureus 2022; 14:e27109. [PMID: 36000118 PMCID: PMC9391612 DOI: 10.7759/cureus.27109] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/21/2022] [Indexed: 11/05/2022] Open
Abstract
Background: Lacrimal gland tumors are rare with data limited to very few large studies. Contemporary strategies like orbit sparing surgeries and neoadjuvant intraarterial chemotherapy remain controversial. Methods: This is a retrospective cohort analysis of epithelial lacrimal gland tumors from the 2004-2016 National Cancer Database. Patients were stratified based on the type of surgery (limited vs destructive) and various treatment modalities employed. Results: Squamous cell carcinoma (33.48%) and adenoid cystic carcinoma (29.45%) were the commonest histologies (N=669). Comparison of limited (46.33%) vs destructive procedures (53.11%) among 482 patients did not show any survival difference, nor the comparison between surgery vs ± chemotherapy vs ± radiotherapy among 472 patients. Conclusion: Squamous cell carcinoma and adenoid cystic carcinoma are the commonest types of lacrimal gland tumors seen in our study. Tumor spread from adjacent sites may have contributed to the higher percentage of squamous cell carcinomas seen. The type of surgery or chemoradiation use did not alter survival.
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10
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Salim N, Libson E, Tumanova K, Krotenkova I. Stereotactic radiosurgery as a successful method to control meningeal metastatic adenoid cystic carcinoma of the lacrimal gland: A case report. Mol Clin Oncol 2022; 17:135. [PMID: 35949893 PMCID: PMC9353865 DOI: 10.3892/mco.2022.2568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Accepted: 06/22/2022] [Indexed: 11/06/2022] Open
Abstract
Adenoid cystic carcinoma (ACC) of the lacrimal gland is a rare tumor. In addition, considering the lack of data on large groups of patients there is no standard of care to treat patients with multiple meningeal metastases of ACC. A two-year analysis of the course of the disease in a patient with synchronous oligometastatic ACC of the lacrimal gland that was treated with stereotactic radiosurgery (SRS) is presented. The aim of the present case report was to evaluate the effect of SRS in the treatment of a patient with ACC. Preliminary results confirmed that this method was highly effective in this patient. The patient is currently living with a good quality of life, normal vision and with no evidence of disease or complications. SRS exhibited reliable local tumor control and insignificant radiation-related complications, rendering it an encouraging treatment option for patients with recurrent or metastatic ACC.
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Affiliation(s)
- Nidal Salim
- Department of Radiation Oncology, European Medical Center, Moscow 129090, Russia
| | - Evgeniy Libson
- Department of Diagnostic Imaging, European Medical Center, Moscow 129090, Russia
| | - Kristina Tumanova
- Department of Radiation Oncology, European Medical Center, Moscow 129090, Russia
| | - Irina Krotenkova
- Department of Diagnostic Imaging, European Medical Center, Moscow 129090, Russia
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11
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Yamazaki H, Suzuki G, Aibe N, Shiomi H, Oh RJ, Yoshida K, Nakamura S, Ogita M. Reirradiation for Rare Head and Neck Cancers: Orbit, Auditory Organ, and Salivary Glands. Cureus 2022; 14:e22727. [PMID: 35308727 PMCID: PMC8920751 DOI: 10.7759/cureus.22727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/28/2022] [Indexed: 11/16/2022] Open
Abstract
We analyzed the efficacy and toxicity following reirradiation for locoregional recurrence of rare head and neck tumors. We retrospectively analyzed 17 patients who had received reirradiation for rare head and neck tumors. Primary tumor sites included nine ears (auditory organ), four salivary glands, and four orbits. The median follow-up time was 13.2 months for surviving patients. The median survival time was 12.6 months with one- and two-year survival rates of 53.1% and 44.3%, respectively. Nine out of 17 patients experienced local failure. The one- and two-year local control rates were 42.4% and 31.8%, respectively. The median survival times were 12.6, 5.3, and 11.0 months for orbit, auditory organ, and salivary glands, respectively. Three patients experienced grade 3 toxicity, including meningitis, brain necrosis, and facial nerve disorders. No grade ≥4 toxicities were observed. Reirradiation of rare head and neck tumors is feasible, with acceptable toxicity.
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12
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AlSemari MA, Strianese D, Abu Safieh L, Al Hussain H, Abedalthagafi M, Edward DP. Expression of Programmed Cell Death-L1 (PD-L1) Protein and Mismatch Repair Mutations in Orbital Tumours-a Pilot Study. Eur J Ophthalmol 2021; 32:3097-3102. [PMID: 34931541 DOI: 10.1177/11206721211066203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE Programmed cell death protein 1 (PD-1) and DNA mismatch repair (MMR) deficiency play an important role in tumour progression and response to treatment.Both markers have been studied in some ocular tumours but little is known about these markers in orbital tumours. This pilot study reports on PD-L1 expression and MMR mutations using next generation sequencing (NGS) in specific orbital tumours. METHODS We reviewed surgical specimens from patients with rhabdomyosarcoma, adenoid cystic carcinoma (ACC), pleomorphic adenoma (PA) and biopsy negative tissue from orbital tumours used as a control. immunohistochemistry (IHC) was performed on Formalin fixed paraffin embedded tissue using a PD-L1 antibody. DNA was extracted for targeted gene panel NGS of the MMR genes PMS2, MLH1, MSH6 and MSH2. RESULTS The study included 17 orbital specimens. Scattered membrane PD-L1 staining was noted in 3/6 rhabdomyosarcoma specimens without an accompanying lymphocytic infiltrate. PD-L1 immunostaining was absent in 3/3 ACC, and 5/6 PA specimens. PD-L1 immunostaining was not detected in 2/2 control specimens. 4/17 samples shared the same pathogenic mutation in the MLH1 gene, including 3/6 rhabdomyosarcoma and 1/3 ACC samples. 1/6 PA samples had a mutation in MSH6. CONCLUSIONS Our study demonstrated scattered, non-quantifiable or absent PD-L1 staining in a limited sample of orbital tumours suggesting that PD-1/PD-L1 inhibitor therapy may not be useful in treatment of malignant orbital tumours (rhabdomyosarcoma and ACC) when refractory to conventional therapy. Our pilot study suggest that PD-L1/MMR axis might not play a major role in the pathogenesis of primary orbital tumour.
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Affiliation(s)
| | - Diego Strianese
- 46670King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia.,Department of Neuroscience, University of Naples Federico II School of Medicine and Surgery, Italy
| | - Leen Abu Safieh
- Genomic Research Department, 37849King Fahad Medical City, Riyadh, Saudi Arabia.,Saudi Human Genome Project, 83527King Abdulaziz City for Science and Technology, Riyadh, Saudi Arabia
| | | | - Malak Abedalthagafi
- Genomic Research Department, 37849King Fahad Medical City, Riyadh, Saudi Arabia.,Saudi Human Genome Project, 83527King Abdulaziz City for Science and Technology, Riyadh, Saudi Arabia
| | - Deepak P Edward
- 46670King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia.,Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago College of Medicine12247, Chicago, USA
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13
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Manjandavida FP, Honavar SG, Murthy R, Das S, Vemuganti GK, Mulay K, Reddy VAP. Does Multimodal Treatment Improve Eye and Life Salvage in Adenoid Cystic Carcinoma of the Lacrimal Gland? Ophthalmic Plast Reconstr Surg 2021. [PMID: 34873122 DOI: 10.1097/IOP.0000000000002108] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
PURPOSE To evaluate the efficacy of multimodal treatment in adenoid cystic carcinoma (ACC) of the lacrimal gland. METHODS A retrospective comparative case series of 40 consecutive patients with ACC of the lacrimal gland without systemic metastasis at the initial presentation and primarily managed by one of the 3 treatment protocols-surgery + external beam radiotherapy (EBRT) (group 1), surgery + EBRT + adjuvant chemotherapy (group 2), and neoadjuvant chemotherapy + surgery + EBRT + adjuvant chemotherapy (multimodal treatment) (group 3) at a tertiary care ocular oncology center. Local tumor control, eye salvage, and systemic metastasis were the primary outcome measures. RESULTS The age ranged from 11 to 72 (mean ± SD, 36 ± 13; median, 36) years with 26 (65%) male and 14 (35%) female patients. Twelve (30%) patients belonged to group 1, 8 (20%) to group 2, and 20 (50%) to group 3. Primary surgery included tumor excision in 36 (90%) and orbital exenteration in 4 (10%). Chemotherapy composed of cisplatin + 5 fluorouracil (5FU) for 6 cycles in 28 (70%) patients. Extended-field stereotactic EBRT with a dose of 5,000-6,000 cGy included the entire pretreatment extent of the tumor with a 10-mm margin all around, superior orbital fissure, inferior orbital fissure, cavernous sinus, and temporal fossa. Mean duration of follow up after completion of treatment was 58 ± 26 (range, 29-180; median, 60) months. In all, local tumor recurrence occurred in 10 (25%) patients at a mean of 38 ± 23 (range, 12-120; median, 24) months. Local tumor recurrence was noted in 5 (42%) patients in group 1, 2 (25%) in group 2, and 3 (15%) in group 3. Overall, eye salvage was possible in 34 (85%) patients, with visual acuity >20/40 in 28 (82%). Systemic metastasis occurred in 10 (25%) patients at a mean of 53 ± 28 (range, 12-120; median, 43) months. Eight (67%) patients in group 1, 1 (13%) in group 2, and 1 (5%) in group 3 developed systemic metastasis. Six (15%) overall, 5 (42%) in group 1 and 1 (13%) in group 2, died with systemic metastasis. CONCLUSIONS Multimodal treatment with sequential neoadjuvant chemotherapy, followed by surgery, extended-field stereotactic EBRT, and adjuvant chemotherapy seems relatively more effective in providing local tumor control and eye salvage and in minimizing the risk of systemic metastasis in ACC of the lacrimal gland.
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14
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Benali K, Benmessaoud H, Aarab J, Nourreddine A, Kacemi HE, Majjaoui SE, Kebdani T, Benjaafar N. Lacrimal gland adenoid cystic carcinoma: report of an unusual case with literature review. Radiat Oncol J 2021; 39:152-158. [PMID: 34619831 PMCID: PMC8497861 DOI: 10.3857/roj.2021.00122] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Accepted: 03/29/2021] [Indexed: 11/03/2022] Open
Abstract
Lacrimal gland adenoid cystic carcinomas are rare, aggressive orbital tumors characterized by poor overall prognosis, tendency for local recurrence and metastasis despite aggressive treatment. Treatment continues to be controversial. Many authorities today will often initiate surgery (orbital exenteration with or without bone removal vs. globe-sparing resection) and adjuvant radiotherapy (external beam or proton beam therapy). We introduce a case of lacrimal gland adenoid cystic carcinoma treated with orbital exenteration and adjuvant volumetric modulated arc therapy, and discuss the related literature.
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Affiliation(s)
- Kenza Benali
- Department of Radiation Oncology, National Institute of Oncology, Rabat, Morocco.,Faculty of Medicine, Mohammed V University, Rabat, Morocco
| | - Houda Benmessaoud
- Department of Radiation Oncology, National Institute of Oncology, Rabat, Morocco.,Faculty of Medicine, Mohammed V University, Rabat, Morocco
| | - Jihan Aarab
- Department of Radiation Oncology, National Institute of Oncology, Rabat, Morocco.,Faculty of Medicine, Mohammed V University, Rabat, Morocco
| | - Abdelati Nourreddine
- Department of Radiation Oncology, National Institute of Oncology, Rabat, Morocco.,Équipe de Science de la Matière et du Rayonnement, Department of Physics, Mohammed V University, Faculty of Science, Rabat, Morocco
| | - Hanan El Kacemi
- Department of Radiation Oncology, National Institute of Oncology, Rabat, Morocco.,Faculty of Medicine, Mohammed V University, Rabat, Morocco
| | - Sanaa El Majjaoui
- Department of Radiation Oncology, National Institute of Oncology, Rabat, Morocco.,Faculty of Medicine, Mohammed V University, Rabat, Morocco
| | - Tayeb Kebdani
- Department of Radiation Oncology, National Institute of Oncology, Rabat, Morocco.,Faculty of Medicine, Mohammed V University, Rabat, Morocco
| | - Noureddine Benjaafar
- Department of Radiation Oncology, National Institute of Oncology, Rabat, Morocco.,Faculty of Medicine, Mohammed V University, Rabat, Morocco
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15
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Duarte AF, Alpuim Costa D, Caçador N, Boavida AM, Afonso AM, Vilares M, Devoto M. Adenoid cystic carcinoma of the palpebral lobe of the lacrimal gland - case report and literature review. Orbit 2021; 41:605-610. [PMID: 33749533 DOI: 10.1080/01676830.2021.1901293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Epithelial tumors of the lacrimal gland are rare and usually develop in the orbital lobe. We report the exceedingly rare occurrence of a primary adenoid cystic carcinoma in the palpebral lobe of the lacrimal gland. A 26-year-old female was referred for evaluation of a gradually enlarging mass in the lateral upper eyelid, previously diagnosed as a chalazion. Computed tomography revealed a heterogeneous round lesion anterior to the orbital rim. Excisional biopsy was compatible with an adenoid cystic carcinoma. After excluding distant metastasis, and as the patient refused adjuvant radiotherapy, a second surgical procedure, with wide local excision, was indicated. Follow-up showed no recurrence. This case highlights the importance of performing a thorough clinical examination when diagnosing any lateral upper eyelid mass. A high index of suspicion for malignant tumors of the lacrimal gland should always be maintained, and a complete excision with histological analysis should be preferred whenever possible.
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Affiliation(s)
- Ana Filipa Duarte
- Department of Ophthalmology, Hospital CUF Descobertas, Lisbon, Portugal
| | | | - Nuno Caçador
- Department of Radiology, Hospital CUF Descobertas, Lisbon, Portugal
| | | | - Ana M Afonso
- Department of Pathology, Hospital CUF Descobertas, Lisbon, Portugal
| | - Miguel Vilares
- Department of Head and Neck Surgery, Instituto Português de Oncologia de Lisboa Francisco Gentil E.P.E. (IPOL-FG), Lisbon, Portugal
| | - Martin Devoto
- Department of Ophthalmology, Clinica Consultores Oftalmológicos, Buenos Aires, Argentina
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16
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Tom A, Bell D, Ford JR, Debnam JM, Guo Y, Frank SJ, Esmaeli B. Malignant Mixed Tumor (Carcinoma Ex Pleomorphic Adenoma) of the Lacrimal Gland. Ophthalmic Plast Reconstr Surg 2020; 36:497-502. [PMID: 32282452 DOI: 10.1097/IOP.0000000000001625] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE To review the clinical presentation, treatment, and prognosis of patients with malignant mixed tumor (carcinoma ex pleomorphic adenoma) of the lacrimal gland. METHODS Clinical records and radiographic images were reviewed for patients with malignant mixed tumor of the lacrimal gland treated at the center during 2008-2019. RESULTS The study included 9 patients (6 men, 3 women) aged 17-66 years (median age, 56 years). Six had primary malignant mixed tumor with no history of orbital lesions, and 3 had previously been diagnosed with pleomorphic adenoma. Tumor, Node, Metastasis classification per the eighth edition of the American Joint Committee on Cancer (AJCC) Cancer Staging Manual were T1aN0M0 in 2 patients, T2aN0M0 in 3 patients, T4bN0M0 in 2 patients, and T4cN0M0 in 2 patients. Two patients underwent orbital exenteration, 6 patients underwent eye-sparing surgery, and 1 patient had an unresectable tumor because of cavernous sinus extension. All patients received radiotherapy (intensity-modulated radiotherapy in 3 and proton therapy in 6). All patients received chemotherapy, 8 concurrently with radiotherapy and 1 after radiotherapy. The median follow-up time was 70 months. At last contact, 6 patients were alive without evidence of disease; 2 had died of disease, 1 of distant metastasis, and the other of cavernous sinus invasion. CONCLUSIONS The findings suggest that de novo malignant mixed tumor of the lacrimal gland is more common than disease that results from transformation after incomplete resection of lacrimal gland pleomorphic adenoma. Most cases can be treated with eye-sparing surgery and radiation unless skull base extension is present.
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17
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Lin YH, Huang SM, Yap WK, Yang JW, Yeung L, Tsan DL, Chang JTC, Chen LC. Outcomes in patients with lacrimal gland carcinoma treated with definitive radiotherapy or eye-sparing surgery followed by adjuvant radiotherapy. Radiat Oncol 2020; 15:156. [PMID: 32571366 PMCID: PMC7310012 DOI: 10.1186/s13014-020-01601-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Accepted: 06/16/2020] [Indexed: 11/10/2022] Open
Abstract
Background The optimal treatment for lacrimal gland cancer remains unclear. Eye-preserving surgery, as opposed to exenteration, followed by adjuvant radiotherapy (RT), has recently been reported to deliver satisfactory outcomes, but evidence is sparse. The aim of the present study was to evaluate outcomes in patients with lacrimal gland cancer treated at two tertiary medical centers. Methods We retrospectively examined data from patients with lacrimal gland cancer who had received eye-preserving surgical treatment followed by adjuvant RT with or without chemotherapy, or (if the tumor was inoperable) needle biopsy with definitive RT with or without chemotherapy. Baseline clinical and pathological characteristics were considered. Outcomes of interest included post-treatment complications, overall survival (OS), locoregional progression-free survival (LPFS), and distant metastasis-free survival (DMFS). Results Eighteen patients were included. Two-year OS, LPFS, and DMFS rates were 69.0, 76.7, and 71.4%, respectively. Patients with early-stage (T1–T2) lacrimal gland cancer had significantly better outcomes than those with advanced-stage disease (T3–T4). Two-year OS, LPFS, and DMFS rates were each 100% in patients with disease stages T1–T2, and 37.5, 50, and 37.5%, respectively, in those with disease stages T3–T4 (P < 0.05). Orbital complications were well tolerated. Conclusions Eye-sparing surgery with adjuvant RT can achieve satisfactory results in patients with T1–T2 lacrimal gland carcinoma. Disease stage T3 and above was associated with poor outcomes even with post-operative RT, likely due to distant metastasis. Adding neoadjuvant chemotherapy or adjuvant chemotherapy to current treatment strategies might be a suitable choice for this group of patients.
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Affiliation(s)
- Yun-Hsuan Lin
- Department of Electro-Optical Engineering, National Taipei University of Technology, 1, Sec. 3, Chung-Hsiao E. Rd, Taipei, 10608, Taiwan, ROC.,Department of Ophthalmology, Chang Gung Memorial Hospital, Keelung, Taiwan.,College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Shih-Ming Huang
- College of Medicine, Chang Gung University, Taoyuan, Taiwan.,Department of Radiation Oncology, Chang Gung Memorial Hospital, Keelung, Taiwan.,Department of Radiation Oncology, Chang Gung Memorial Hospital, Linkou, Taiwan
| | - Wing-Keen Yap
- Department of Radiation Oncology, Chang Gung Memorial Hospital, Linkou, Taiwan
| | - Ju-Wen Yang
- Department of Ophthalmology, Chang Gung Memorial Hospital, Keelung, Taiwan.,College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Ling Yeung
- Department of Ophthalmology, Chang Gung Memorial Hospital, Keelung, Taiwan.,College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Din-Li Tsan
- Department of Radiation Oncology, Chang Gung Memorial Hospital, Keelung, Taiwan
| | | | - Lung-Chien Chen
- Department of Electro-Optical Engineering, National Taipei University of Technology, 1, Sec. 3, Chung-Hsiao E. Rd, Taipei, 10608, Taiwan, ROC.
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18
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Bonavolontà P, Esmaeli B, Donna P, Tranfa F, Iuliano A, Abbate V, Fossataro F, Attanasi F, Bonavolontà G. Outcomes after eye‐sparing surgery vs orbital exenteration in patients with lacrimal gland carcinoma. Head Neck 2020; 42:988-993. [DOI: 10.1002/hed.26073] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2018] [Revised: 12/10/2019] [Accepted: 12/31/2019] [Indexed: 11/10/2022] Open
Affiliation(s)
- Paola Bonavolontà
- Department of Neuroscience Reproductive Sciences and Odontostomatology, Maxillofacial Surgery Section, Federico II University of Naples Naples Italy
| | - Bita Esmaeli
- Orbital Oncology and Ophthalmic Plastic Surgery, Department of Plastic Surgery The University of Texas MD Anderson Cancer Center Houston Texas
| | - Piero Donna
- Department of Neuroscience Reproductive Sciences and Odontostomatology, Ophthalmology Section, Federico II University of Naples Naples Italy
| | - Fausto Tranfa
- Department of Neuroscience Reproductive Sciences and Odontostomatology, Ophthalmology Section, Federico II University of Naples Naples Italy
| | - Adriana Iuliano
- Department of Neuroscience Reproductive Sciences and Odontostomatology, Ophthalmology Section, Federico II University of Naples Naples Italy
| | - Vincenzo Abbate
- Department of Neuroscience Reproductive Sciences and Odontostomatology, Maxillofacial Surgery Section, Federico II University of Naples Naples Italy
| | - Federica Fossataro
- Department of Neuroscience Reproductive Sciences and Odontostomatology, Ophthalmology Section, Federico II University of Naples Naples Italy
| | - Federica Attanasi
- Statistical Science Department, School of Statistic Science University of Rome “La Sapienza” Rome Italy
| | - Giulio Bonavolontà
- Department of Neuroscience Reproductive Sciences and Odontostomatology, Ophthalmology Section, Federico II University of Naples Naples Italy
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19
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Hu W, Hu J, Gao J, Yang J, Qiu X, Kong L, Lu JJ. Outcomes of orbital malignancies treated with eye-sparing surgery and adjuvant particle radiotherapy: a retrospective study. BMC Cancer 2019; 19:776. [PMID: 31387548 PMCID: PMC6685259 DOI: 10.1186/s12885-019-5964-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2019] [Accepted: 07/22/2019] [Indexed: 12/16/2022] Open
Abstract
Background To report the clinical experience of eye sparing surgery (ESS) and adjuvant carbon-ion or proton radiotherapy (CIRT or PRT) for orbital malignancies. Methods An analysis of the retrospective data registry from the Shanghai Proton and Heavy Ion Center for patients with orbital tumors was conducted. The 2-year local progression-free, regional recurrence-free, distant metastasis-free, progression-free, and overall survival (LPFS, RRFS, DMFS, PFS, OS) rates as well as associated prognostic indicators were analyzed. Radiotherapy-induced acute and late toxicities were summarized. Results Between 7/2014 to 5/2018, 22 patients with orbital malignancies of various pathologies received ESS followed by CIRT (18), PRT (1), or PRT + CIRT boost (3). With a median follow-up of 20.25 (range 3.8–38.8) months, the 2-year OS, PFS, LPFS, RRFS, and DMFS rates were 100, 57.9, 92.9, 93.3, and 72.8%, respectively. No acute severe (i.e., ≥grade 3) toxicity was observed. Two patients experienced severe visual impairment as late toxicities. Conclusion With few observed acute and late toxicities, particle radiotherapy following ESS provided effective local control with infrequent severe toxicities for patients with orbital malignancies.
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Affiliation(s)
- Weixu Hu
- Department of Radiation Oncology, Shanghai Proton and Heavy Ion Center, Shanghai, China.,Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy, 4365 Kangxin Road, Pudong, Shanghai, 201321, China
| | - Jiyi Hu
- Department of Radiation Oncology, Shanghai Proton and Heavy Ion Center, Shanghai, China.,Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy, 4365 Kangxin Road, Pudong, Shanghai, 201321, China
| | - Jing Gao
- Department of Radiation Oncology, Shanghai Proton and Heavy Ion Center, Shanghai, China.,Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy, 4365 Kangxin Road, Pudong, Shanghai, 201321, China
| | - Jing Yang
- Department of Radiation Oncology, Shanghai Proton and Heavy Ion Center, Shanghai, China.,Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy, 4365 Kangxin Road, Pudong, Shanghai, 201321, China
| | - Xianxin Qiu
- Department of Radiation Oncology, Shanghai Proton and Heavy Ion Center, Shanghai, China.,Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy, 4365 Kangxin Road, Pudong, Shanghai, 201321, China
| | - Lin Kong
- Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy, 4365 Kangxin Road, Pudong, Shanghai, 201321, China. .,Department of Radiation Oncology, Shanghai Proton and Heavy Ion Center, Fudan University Shanghai Cancer Center, Shanghai, China.
| | - Jiade J Lu
- Department of Radiation Oncology, Shanghai Proton and Heavy Ion Center, Shanghai, China. .,Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy, 4365 Kangxin Road, Pudong, Shanghai, 201321, China.
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20
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Everett LA, Copperman TS, Kersten RC. A Case of Lacrimal Gland Ductal Carcinoma With Regional Lymph Node Metastasis. Ophthalmic Plast Reconstr Surg 2019; 35:e118-21. [PMID: 31365510 DOI: 10.1097/IOP.0000000000001447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Ductal carcinoma of the lacrimal gland is a very rare and aggressive neoplasm, with clinical and histopathologic similarities to salivary ductal carcinoma. Of the 25 previously reported cases, 2 patients had metastases to local lymph nodes confirmed on pathologic examination. The authors now report the clinical presentation, histopathologic and immunohistochemical features, and the treatment of a third patient with lacrimal gland ductal carcinoma with spread to local lymph nodes. In contrast to ductal carcinoma, lymph node involvement has not been reported in the largest series of adenoid cystic carcinoma, a much more common lacrimal gland malignancy. This case highlights the need for possible lymph node surveillance in patients with lacrimal gland ductal carcinoma.
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Hung J, Wei Y, Huang C, Chen L, Fuh C, Liao S. Survival outcomes of eye-sparing surgery for adenoid cystic carcinoma of lacrimal gland. Jpn J Ophthalmol 2019; 63:344-351. [DOI: 10.1007/s10384-019-00671-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
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22
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Hung JY, Wei YH, Huang CH, Chen LW, Fuh CS, Liao SL. Survival outcomes of eye-sparing surgery for adenoid cystic carcinoma of lacrimal gland. Jpn J Ophthalmol 2019; 63:344-351. [PMID: 31134459 DOI: 10.1007/s10384-019-00671-w] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2018] [Accepted: 04/23/2019] [Indexed: 02/06/2023]
Abstract
PURPOSE To survey adenoid cystic carcinoma of lacrimal glands in Asian population and investigate the predictability in prognosis following the 8th edition American Joint Committee on Cancer (AJCC) staging guideline. STUDY DESIGN Retrospective study. METHODS The clinical entities and surgical outcomes of the patients who were histologically confirmed with a diagnosis of lacrimal adenoid cystic carcinoma in National Taiwan University Hospital between January 1995 and December 2015 were retrospectively reviewed. RESULTS Enrolled were 11 patients. The median follow-up was 7.2 years. Eight patients (72.7%) were diagnosed as T1 or T2 disease, and three patients (27.3%) were diagnosed as T3 or T4 disease according to the AJCC 8th edition guideline. Eye-sparing surgery with radiotherapy was performed in nine patients. Local recurrence was noted in six patients (54.5%) with median disease-free interval of 23.5 months. Six patients (54.5%) developed distant metastases, including lung, bone, and cranial invasions. Overall survival rate during the study period was 54.6%. Five-year overall survival was 81.8% and ten-year overall survival was 68.2%. The Log-rank test for overall survival and disease-free survival between patients with less than T3 disease (p=0.001) and patients with T3 or T4 disease (p=0.006) revealed significant differences. CONCLUSION This study highlighted the aggressive nature of adenoid cystic carcinoma of lacrimal glands. Eye-sparing surgery with adjunctive radiotherapy may achieve relatively optimal disease control in diseases staged T1 or T2, but in advanced disease metastasis and mortality are usually inevitable.
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Affiliation(s)
- Ju-Yi Hung
- Department of Ophthalmology, Taipei Medical University Hospital, No. 252, Wuxing St, Xinyi District, Taipei City, Taiwan.,Department of Computer Science and Information Engineering, National Taiwan University, No. 1, Sec. 4, Roosevelt Road, Taipei City, Taiwan
| | - Yi-Hsuan Wei
- Department of Ophthalmology, National Taiwan University Hospital, No. 7, Zhongshan S. Rd., Zongzheng Dist., Taipei City, Taiwan
| | - Chu-Hsuan Huang
- Department of Ophthalmology, National Taiwan University Hospital, No. 7, Zhongshan S. Rd., Zongzheng Dist., Taipei City, Taiwan
| | - Lily-Wei Chen
- College of Medicine, University of Massachusetts, Boston, USA.,University of Massachusetts, 55 Lake Avenue North, Worcester, MA, 01655, USA
| | - Chiou-Shann Fuh
- Department of Computer Science and Information Engineering, National Taiwan University, No. 1, Sec. 4, Roosevelt Road, Taipei City, Taiwan
| | - Shu-Lang Liao
- Department of Ophthalmology, National Taiwan University Hospital, No. 7, Zhongshan S. Rd., Zongzheng Dist., Taipei City, Taiwan. .,College of Medicine, National Taiwan University, No. 1, Jen Ai Road, Section 1, Taipei City, Taiwan.
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Woo KI, Sagiv O, Han J, Frank SJ, Kim YD, Esmaeli B. Eye-Preserving Surgery Followed by Adjuvant Radiotherapy for Lacrimal Gland Carcinoma: Outcomes in 37 Patients. Ophthalmic Plast Reconstr Surg 2018; 34:570-4. [PMID: 29634603 DOI: 10.1097/IOP.0000000000001106] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE To describe the clinical outcomes of eye-preserving surgery followed by adjuvant radiotherapy in patients with lacrimal gland carcinoma. METHODS Thirty-seven patients with lacrimal gland carcinoma who underwent eye-preserving surgery were studied. RESULTS At last follow up, 32 patients were alive without disease, 3 patients were alive with disease with distant metastasis, 1 patient had died of disease, and 1 patient had died of other cause. The 5-year recurrence-free survival rate was worse in patients without than in patients with adjuvant radiotherapy (p = 0.001) and worse in patients with T3-T4 tumors than in patients with T1-T2 tumors (p = 0.027). At last follow up, 25 patients (68%) had visual acuity of 20/40 or better. CONCLUSIONS In patients with lacrimal gland carcinoma, eye-preserving surgery and adjuvant radiotherapy is associated with reasonable local control rates and visual and ocular function. Postoperative adjuvant radiotherapy seems to enhance local control rates.
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Akbaba S, Lang K, Held T, Herfarth K, Rieber J, Plinkert P, Auffarth GU, Rieken S, Debus J, Adeberg S. Carbon-ion radiotherapy in accelerated hypofractionated active raster-scanning technique for malignant lacrimal gland tumors: feasibility and safety. Cancer Manag Res 2019; 11:1155-1166. [PMID: 30774443 PMCID: PMC6362930 DOI: 10.2147/cmar.s190051] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Introduction We evaluated treatment outcomes of CIRT in an active raster-scanning technique alone or in combination with IMRT for lacrimal gland tumors. Methods A total of 24 patients who received CIRT for a malignant lacrimal gland tumor at the HIT between 2009 and 2018 were analyzed retrospectively for LC, OS, and distant progression-free survival (DPFS) using Kaplan-Meier estimates. Toxicity was assessed according to the CTCAE version 5. Results Median follow-up was 30 months and overall median LC, OS, and DPFS 24 months, 36 months, and 31 months, respectively. Two-year LC, OS, and DPFS of 93%, 96%, and 87% with CIRT was achieved for all patients. Local failure occurred only in patients with ACC and after a median follow-up of 30 months after the completion of RT (n=5, 21%; P=0.09). We identified a significant negative impact of a macroscopic tumor disease, which was diagnosed on planning CT or MRI before RT, on LC (P=0.026). In contrast, perineural spread (P=0.661), T stage (P=0.552), and resection margins in operated patients (P=0.069) had no significant impact on LC. No grade ≥3 acute or grade >3 chronic toxicity occurred. Late grade 3 side effects were identified in form of a wound-healing disorder 3 months after RT in one patient and temporal lobe necrosis 6 months after RT in another (n=2, 8%). Conclusion Accelerated hypofractionated active raster-scanning CIRT for relative radio-resistant malignant lacrimal gland tumors results in adequate LC rates and moderate acute and late toxicity. Nevertheless, LC for ACC histology remains challenging and risk factors for local recurrence are still unclear. Further follow-up is necessary to evaluate long-term clinical outcome.
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Affiliation(s)
- Sati Akbaba
- Department of Radiation Oncology, University Hospital Heidelberg, Heidelberg 69120, Germany, .,Heidelberg Institute of Radiation Oncology (HIRO), National Center for Radiation Research in Oncology (NCRO), University Hospital Heidelberg, Heidelberg 69120, Germany, .,Heidelberg Ion-Beam Therapy Center (HIT), University Hospital Heidelberg, Heidelberg 69120, Germany,
| | - Kristin Lang
- Department of Radiation Oncology, University Hospital Heidelberg, Heidelberg 69120, Germany, .,Heidelberg Institute of Radiation Oncology (HIRO), National Center for Radiation Research in Oncology (NCRO), University Hospital Heidelberg, Heidelberg 69120, Germany,
| | - Thomas Held
- Department of Radiation Oncology, University Hospital Heidelberg, Heidelberg 69120, Germany, .,Heidelberg Institute of Radiation Oncology (HIRO), National Center for Radiation Research in Oncology (NCRO), University Hospital Heidelberg, Heidelberg 69120, Germany,
| | - Klaus Herfarth
- Department of Radiation Oncology, University Hospital Heidelberg, Heidelberg 69120, Germany, .,Heidelberg Institute of Radiation Oncology (HIRO), National Center for Radiation Research in Oncology (NCRO), University Hospital Heidelberg, Heidelberg 69120, Germany, .,Heidelberg Ion-Beam Therapy Center (HIT), University Hospital Heidelberg, Heidelberg 69120, Germany,
| | - Juliane Rieber
- Department of Radiation Oncology, University Hospital Heidelberg, Heidelberg 69120, Germany, .,Heidelberg Institute of Radiation Oncology (HIRO), National Center for Radiation Research in Oncology (NCRO), University Hospital Heidelberg, Heidelberg 69120, Germany, .,Heidelberg Ion-Beam Therapy Center (HIT), University Hospital Heidelberg, Heidelberg 69120, Germany,
| | - Peter Plinkert
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Heidelberg, Heidelberg 69120, Germany
| | - Gerd U Auffarth
- Department of Ophthalmology, University Hospital Heidelberg, Heidelberg 69120, Germany
| | - Stefan Rieken
- Department of Radiation Oncology, University Hospital Heidelberg, Heidelberg 69120, Germany, .,Heidelberg Institute of Radiation Oncology (HIRO), National Center for Radiation Research in Oncology (NCRO), University Hospital Heidelberg, Heidelberg 69120, Germany, .,Heidelberg Ion-Beam Therapy Center (HIT), University Hospital Heidelberg, Heidelberg 69120, Germany,
| | - Juergen Debus
- Department of Radiation Oncology, University Hospital Heidelberg, Heidelberg 69120, Germany, .,Heidelberg Institute of Radiation Oncology (HIRO), National Center for Radiation Research in Oncology (NCRO), University Hospital Heidelberg, Heidelberg 69120, Germany, .,Heidelberg Ion-Beam Therapy Center (HIT), University Hospital Heidelberg, Heidelberg 69120, Germany,
| | - Sebastian Adeberg
- Department of Radiation Oncology, University Hospital Heidelberg, Heidelberg 69120, Germany, .,Heidelberg Institute of Radiation Oncology (HIRO), National Center for Radiation Research in Oncology (NCRO), University Hospital Heidelberg, Heidelberg 69120, Germany, .,Heidelberg Ion-Beam Therapy Center (HIT), University Hospital Heidelberg, Heidelberg 69120, Germany,
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Kim SE, Baek HJ, Park EJ, Lim SC, Kim SS. Loss of BRCA1 Spontaneously Induces the Tumorigenesis in Lacrimal Gland. Anal Cell Pathol (Amst) 2018; 2018:8120579. [PMID: 30652068 DOI: 10.1155/2018/8120579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Environmental and genetic factors exert important influences on lifespan and neoplastic transformation. We have previously shown that spontaneous tumors form frequently in mice homozygous for a full-length Brca1 deletion. In general, mutations of BRCA1 are closely associated with induction of breast and ovarian cancers but are also known to contribute to the incidence of other cancers at a low frequency. Female Brca1-mutant mice (Brca1co/coMMTV-cre) were generated by crossing Brca1 conditional knockout mice and MMTV-cre mice, and the occurrence of lacrimal gland abnormalities and tumors was followed until mice reached 18 months of age. Lacrimal gland tumors, which occur at a very low frequency in the human population (1 per 1,000,000 per year), were detected in 7 cases of Brca1co/coMMTV-cre mice (2.75%) older than 9 months of age. None of seven mice exhibited any abnormality in the mammary gland including neoplasia, suggesting lacrimal gland tumor is spontaneously and independently formed. These tumors, which were detected in seven mutant mice that displayed exophthalmoses, were malignant, originated from epithelial cells, and were identified as acinic cell carcinoma by pathological analysis. Further analysis revealed that tumorigenesis was accompanied by the accumulation of cyclin D1 and decreased expression of the cellular oncogenes, c-Myc, c-Jun, and c-Raf. Tumors also exhibited rearrangement of cytoskeletal proteins, including β-catenin, keratin 5, and vimentin, depending on tumor progression. These results suggest that BRCA1 is involved in genetic stability of the lacrimal gland, providing new insight into genomic instability in organism maintenance and tumorigenesis of the lacrimal gland.
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Doddapaneni R, Tao W, Naranjo A, Nikpoor N, Tse DT, Pelaez D. Fibroblast growth factor receptor 1 (FGFR1) as a therapeutic target in adenoid cystic carcinoma of the lacrimal gland. Oncotarget 2019; 10:480-493. [PMID: 30728899 PMCID: PMC6355187 DOI: 10.18632/oncotarget.26558] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2018] [Accepted: 12/20/2018] [Indexed: 11/25/2022] Open
Abstract
Identification of molecular targets is the first step in developing efficacious therapeutic strategies for tumors. A tumors' biological response to perturbagens yields important information on the molecular determinants for tumor growth. The aim of this study was to characterize the response of adenoid cystic carcinoma of the lacrimal gland (LGACC) to intra-arterial cytoreductive chemotherapy (IACC) in order to identify novel targets to enhance therapy. We performed high-throughput proteomic analysis on paired samples from pre-IACC diagnostic biopsies and post-IACC excised tumor samples from 6 LGACC patients. This proteomic analysis provides a comprehensive landscape of the cellular compartments contained within the excised tumors. Interestingly, we found a strong upregulation across the fibroblast growth factor (FGF) signaling pathway, with FGF receptor 1 (FGFR1) exhibiting a consistent and significant upregulation in all post-IACC samples. We thus evaluated the therapeutic efficacy of a novel FGFR1 selective inhibitor, AZD4547, in combination with cisplatin on LGACC cells in-vitro. The combination index (CI) value (<0.895) demonstrated synergistic effect of AZD4547 and cisplatin in inhibiting cell growth and viability (p<0.02), with a differential response seen in post-IACC cultures when compared to pre-IACC cultures. The combination approach showed synergy of the drugs in the migration assay. Western blot analysis indicated a significant upregulation of cleaved caspase-3 and downregulation the expression of FGFR1 (p<0.05) with the combination treatment as compared to either agent independently. Our findings demonstrate that FGFR1 inhibition potentiates the cytoreductive effects of cisplatin and suggest a potential therapeutic benefit of using AZD4547 in the management of LGACC.
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Affiliation(s)
- Ravi Doddapaneni
- Dr. Nasser Al-Rashid Orbital Vision Research Center, Bascom Palmer Eye Institute, Department of Ophthalmology, University of Miami Miller School of Medicine, Miami, FL 33136, USA
| | - Wensi Tao
- Dr. Nasser Al-Rashid Orbital Vision Research Center, Bascom Palmer Eye Institute, Department of Ophthalmology, University of Miami Miller School of Medicine, Miami, FL 33136, USA
| | - Andrea Naranjo
- Dr. Nasser Al-Rashid Orbital Vision Research Center, Bascom Palmer Eye Institute, Department of Ophthalmology, University of Miami Miller School of Medicine, Miami, FL 33136, USA
| | - Neda Nikpoor
- Dr. Nasser Al-Rashid Orbital Vision Research Center, Bascom Palmer Eye Institute, Department of Ophthalmology, University of Miami Miller School of Medicine, Miami, FL 33136, USA
| | - David T Tse
- Dr. Nasser Al-Rashid Orbital Vision Research Center, Bascom Palmer Eye Institute, Department of Ophthalmology, University of Miami Miller School of Medicine, Miami, FL 33136, USA
| | - Daniel Pelaez
- Dr. Nasser Al-Rashid Orbital Vision Research Center, Bascom Palmer Eye Institute, Department of Ophthalmology, University of Miami Miller School of Medicine, Miami, FL 33136, USA
- Department of Biomedical Engineering, University of Miami Miller School of Medicine, Miami, FL 33136, USA
- Department of Cell Biology, University of Miami Miller School of Medicine, Miami, FL 33136, USA
- Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL 33136, USA
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Park H, Choi SG. Primary sebaceous carcinoma of lacrimal gland: A case report and review of literature. World J Clin Cases 2018; 6:1194-1198. [PMID: 30613681 PMCID: PMC6306633 DOI: 10.12998/wjcc.v6.i16.1194] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2018] [Revised: 11/12/2018] [Accepted: 11/24/2018] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Primary sebaceous carcinoma of lacrimal gland (SCLG) is extremely rare. Due to its clinical characteristics, it is often misdiagnosed. It is known to be aggressive so delay in diagnosis can increase the chance of local recurrence and metastasis. We report a case of primary SCLG.
CASE SUMMARY A 75-year-old man was referred with a painful swelling in the right eyelid. Computed tomography scan demonstrates a 2.6 cm mass in upper outer quadrant of right orbit. After the incisional biopsy of the mass, he was diagnosed with squamous cell carcinoma of lacrimal gland. A right orbital exenteration, cervical lymph node dissection was performed. There was no involvement of the overlying periorbital skin, eyelid, or conjunctiva. Histological examination of the exenteration specimen showed tumor arising from the lacrimal gland, which had been entirely replaced by sebaceous carcinoma with sarcomatous and squamous differentiation. Neoplastic cells which were large and contained prominent nucleoli. Focal tumor remained in the posterior resection margin. Patient underwent adjuvant radiotherapy, total dose of 56 Gy with dose-per-fraction 2 Gy to primary lesion. There has been no sign of recurrence until 2-years follow-up.
CONCLUSION We report a rare case of sebaceous carcinoma arising from the lacrimal gland. Accurate diagnosis of SCLG is important for appropriate treatment and prognosis prediction.
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Affiliation(s)
- Hyojung Park
- Departments of Radiation Oncology, Dankook University Hospital, Dankook University College of Medicine, Cheonan 31116, South Korea
| | - Sang Gyu Choi
- Departments of Radiation Oncology, Dankook University Hospital, Dankook University College of Medicine, Cheonan 31116, South Korea
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Wolkow N, Jakobiec FA, Lee H, Sutula FC. Long-term Outcomes of Globe-Preserving Surgery With Proton Beam Radiation for Adenoid Cystic Carcinoma of the Lacrimal Gland. Am J Ophthalmol 2018; 195:43-62. [PMID: 30071211 DOI: 10.1016/j.ajo.2018.07.024] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2018] [Revised: 07/17/2018] [Accepted: 07/20/2018] [Indexed: 01/24/2023]
Abstract
PURPOSE To describe outcomes of globe-preserving surgery combined with high-dose proton beam radiation (PBR) in treating primary adenoid cystic carcinoma (ACC) of the lacrimal gland. DESIGN Retrospective case series. METHODS Twenty-nine patients with primary ACC of the lacrimal gland were identified in the records of a single institution between 1990 and 2017. Patients with nonorbital primary tumor origins or with inadequate follow-ups were excluded. Eighteen patients met inclusion criteria. Clinical data, imaging studies, histopathology, treatment modality, local recurrences, visual outcomes, metastases, and survivals were assessed. Disease-free survivals for the current patients were measured and compared to those of other studies. RESULTS The eighteen patients (14 female, 4 male) were followed for a median of 12.9 years (range 0.6-22.3 years) after treatment completion. Their median age was 40 years. Four were children (median age 12 years). All were treated with globe-preserving tumor resection and radiation (median dose of 72 cobalt gray equivalents). Three adult patients died of metastatic disease (median of 4.2 years after treatment). Four had local recurrences. Useful vision (20/40 or better) was retained for a median 3 years (range 1-12.9 years). Radiation morbidity included brain injury, retinopathy, optic neuropathy, keratopathy, and cataract. Overall and disease-free survivals were significantly better compared to historical treatments, but did not differ statistically from other modern approaches. CONCLUSIONS Globe-preserving surgery with PBR, although imperfect, has a favorable long-term survival compared to other modern modalities, and offers a variable period of useful vision.
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Affiliation(s)
- Natalie Wolkow
- David Glendenning Cogan Ophthalmic Pathology Laboratory, Department of Ophthalmology, Massachusetts Eye and Ear Infirmary and the Harvard Medical School, Boston, Massachusetts, USA
| | - Frederick A Jakobiec
- David Glendenning Cogan Ophthalmic Pathology Laboratory, Department of Ophthalmology, Massachusetts Eye and Ear Infirmary and the Harvard Medical School, Boston, Massachusetts, USA.
| | - Hang Lee
- Biostatistics Center, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Francis C Sutula
- Department of Ophthalmology, Massachusetts Eye and Ear Infirmary and the Harvard Medical School, Boston, Massachusetts, USA; Sutula Eye Associates, Milton, Massachusetts, USA
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Kim SE, Baek HJ, Park EJ, Lim SC, Kim SS. Loss of BRCA1 Spontaneously Induces the Tumorigenesis in Lacrimal Gland. Anal Cell Pathol (Amst) 2018; 2018:8120579. [PMID: 30652068 PMCID: PMC6311772 DOI: 10.1155/2018/8120579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2018] [Accepted: 10/23/2018] [Indexed: 02/07/2023] Open
Abstract
Environmental and genetic factors exert important influences on lifespan and neoplastic transformation. We have previously shown that spontaneous tumors form frequently in mice homozygous for a full-length Brca1 deletion. In general, mutations of BRCA1 are closely associated with induction of breast and ovarian cancers but are also known to contribute to the incidence of other cancers at a low frequency. Female Brca1-mutant mice (Brca1co/coMMTV-cre) were generated by crossing Brca1 conditional knockout mice and MMTV-cre mice, and the occurrence of lacrimal gland abnormalities and tumors was followed until mice reached 18 months of age. Lacrimal gland tumors, which occur at a very low frequency in the human population (1 per 1,000,000 per year), were detected in 7 cases of Brca1co/coMMTV-cre mice (2.75%) older than 9 months of age. None of seven mice exhibited any abnormality in the mammary gland including neoplasia, suggesting lacrimal gland tumor is spontaneously and independently formed. These tumors, which were detected in seven mutant mice that displayed exophthalmoses, were malignant, originated from epithelial cells, and were identified as acinic cell carcinoma by pathological analysis. Further analysis revealed that tumorigenesis was accompanied by the accumulation of cyclin D1 and decreased expression of the cellular oncogenes, c-Myc, c-Jun, and c-Raf. Tumors also exhibited rearrangement of cytoskeletal proteins, including β-catenin, keratin 5, and vimentin, depending on tumor progression. These results suggest that BRCA1 is involved in genetic stability of the lacrimal gland, providing new insight into genomic instability in organism maintenance and tumorigenesis of the lacrimal gland.
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Affiliation(s)
- Sun Eui Kim
- 1Research Institute, National Cancer Center Research Institute, Goyang 10408, Republic of Korea
| | - Hye Jung Baek
- 1Research Institute, National Cancer Center Research Institute, Goyang 10408, Republic of Korea
| | - Eun Jung Park
- 1Research Institute, National Cancer Center Research Institute, Goyang 10408, Republic of Korea
| | - Sung Chul Lim
- 2Department of Pathology, College of Medicine, Chosun University, Gwangju 61452, Republic of Korea
| | - Sang Soo Kim
- 1Research Institute, National Cancer Center Research Institute, Goyang 10408, Republic of Korea
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Dorbandt DM, Lundberg AP, Roady PJ, Huey JA, Phillips H, Hamor RE. Surgical excision of a feline orbital lacrimal gland adenocarcinoma with adjunctive cryotherapy and carboplatin-impregnated bead implantation. Vet Ophthalmol 2017; 21:419-425. [DOI: 10.1111/vop.12501] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Daniel M. Dorbandt
- Department of Veterinary Clinical Medicine; College of Veterinary Medicine; University of Illinois Urbana-Champaign; 1008 W. Hazelwood Drive Urbana IL 61802 USA
| | - Alycen P. Lundberg
- Department of Veterinary Clinical Medicine; College of Veterinary Medicine; University of Illinois Urbana-Champaign; 1008 W. Hazelwood Drive Urbana IL 61802 USA
| | - Patrick J. Roady
- Veterinary Diagnostic Laboratory; College of Veterinary Medicine; University of Illinois Urbana-Champaign; 2001 S. Lincoln Avenue Urbana IL 61802 USA
| | - Jane A. Huey
- Department of Veterinary Clinical Medicine; College of Veterinary Medicine; University of Illinois Urbana-Champaign; 1008 W. Hazelwood Drive Urbana IL 61802 USA
- Memphis Veterinary Specialists; 555 Trinity Creek Cove Cordova TN 38018 USA
| | - Heidi Phillips
- Department of Veterinary Clinical Medicine; College of Veterinary Medicine; University of Illinois Urbana-Champaign; 1008 W. Hazelwood Drive Urbana IL 61802 USA
| | - Ralph E. Hamor
- Department of Veterinary Clinical Medicine; College of Veterinary Medicine; University of Illinois Urbana-Champaign; 1008 W. Hazelwood Drive Urbana IL 61802 USA
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Andreasen S, Esmaeli B, Holstein SLV, Mikkelsen LH, Rasmussen PK, Heegaard S. An Update on Tumors of the Lacrimal Gland. Asia Pac J Ophthalmol (Phila) 2017; 6:159-172. [PMID: 28399336 DOI: 10.22608/apo.201707] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2017] [Accepted: 02/06/2017] [Indexed: 02/06/2023] Open
Abstract
Lacrimal gland tumors are rare and constitute a wide spectrum of different entities ranging from benign epithelial and lymphoid lesions to high-grade carcinomas, lymphomas, and sarcomas with large differences in prognosis and clinical management. The symptoms and findings of a lacrimal gland lesion are a growing mass at the site of the lacrimal gland, including displacement of the eyeball, decreased motility, diplopia, and ptosis. Pain is the cardinal symptom of an adenoid cystic carcinoma. Radiological findings characteristically include an oval, well-demarcated mass for benign lesions whereas malignant lesions typically display calcifications, destruction of bone, and invasion of adjacent structures. The diagnosis ultimately relies on histology, as does the choice of treatment and the prognosis. In recent years, the understanding of the biology of numerous types of lacrimal gland neoplasia has improved and the choice of treatment has changed accordingly and holds further promise for future targeted therapies. Treatment of benign epithelial lesions is surgical excision whereas carcinomas often require adjuvant radiotherapy and/or chemotherapy. In contrast, the cornerstone in management of lymphoid lesions is chemotherapy, often including a monoclonal antibody. This article presents an update on the clinical, radiological, histological, and molecular features, along with treatment strategies for tumors of the lacrimal gland.
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Affiliation(s)
- Simon Andreasen
- Department of Otorhinolaryngology, Head and Neck Surgery and Audiology, Copenhagen University Hospital, Copenhagen, Denmark
- Department of Otorhinolaryngology and Maxillofacial Surgery, Zealand University Hospital, Køge, Denmark
| | - Bita Esmaeli
- Orbital Oncology and Ophthalmic Plastic Surgery, Department of Plastic Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Sarah Linéa von Holstein
- Department of Ophthalmology, Zealand University Hospital, Roskilde, Denmark
- Department of Pathology, Rigshospitalet, University of Copenhagen, Cophenhagen, Denmark
| | - Lauge Hjorth Mikkelsen
- Department of Pathology, Rigshospitalet, University of Copenhagen, Cophenhagen, Denmark
- Department of Ophthalmology, Rigshospitalet-Glostrup, University of Copenhagen, Copenhagen, Denmark
| | - Peter Kristian Rasmussen
- Department of Pathology, Rigshospitalet, University of Copenhagen, Cophenhagen, Denmark
- Department of Ophthalmology, Rigshospitalet-Glostrup, University of Copenhagen, Copenhagen, Denmark
| | - Steffen Heegaard
- Department of Pathology, Rigshospitalet, University of Copenhagen, Cophenhagen, Denmark
- Department of Ophthalmology, Rigshospitalet-Glostrup, University of Copenhagen, Copenhagen, Denmark
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Maamari RN, Custer PL, Harocopos GJ. Incidentally Discovered Adenoid Cystic Carcinoma of the Lacrimal Gland with Isolated Liver Metastases. Ocul Oncol Pathol 2017; 3:262-266. [DOI: 10.1159/000461585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2016] [Revised: 02/05/2017] [Indexed: 11/19/2022] Open
Abstract
<b><i>Aim:</i></b> To report a rare presentation of adenoid cystic carcinoma (ACC) of the lacrimal gland. <b><i>Method:</i></b> This is a case report presenting clinical, radiographic, and histopathologic findings. <b><i>Results:</i></b> A 72-year-old female with no reported ocular symptoms was found to have an incidental right orbital mass on imaging. Additional studies revealed multiple liver lesions, which were biopsied and found to be consistent with ACC. She was then referred to the ophthalmology service, where ocular examination demonstrated 2.5 mm of right proptosis with elevation and abduction deficits. Diplopia could be elicited in extreme upgaze and right lateral gaze. An excisional biopsy of the orbital mass was performed, with histopathology confirming the diagnosis of primary ACC of the lacrimal gland, thereby also supporting the initial suspicion that the hepatic ACC lesions represented metastases. <b><i>Conclusion:</i></b> The authors describe a rare presentation of ACC of the lacrimal gland, initially asymptomatic, with metastatic lesions restricted to the liver at the time of diagnosis. Three previous cases of ACC with isolated metastatic hepatic lesions at the time of diagnosis have been reported; all of these cases localized the primary tumor to the salivary glands.
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Affiliation(s)
- Hwa Lee
- Department of Ophthalmology, Korea University Ansan Hospital, Korea University College of Medicine, Ansan, Korea
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