Clinical characteristics and treatment outcome of adenoid cystic carcinoma in the external auditory canal
Clinical characteristics and treatment outcome of adenoid cystic carcinoma in the external auditory canal
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DOI：
10.1016/j.bj.2019.07.005
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发表时间：
2020-04-01
影响因子：
5.5
通讯作者：
Chan, Kai-Chieh
中科院分区：
文献类型：
--
作者：
Chen, Shih-Lung;Huang, Shiang-Fu;Chan, Kai-Chieh
背景资料：本研究回顾了外耳道腺样囊性癌（ACC）的临床表现，病理结果和治疗结果（EAC）。方法：这是一个回顾性分析的12例诊断为ACC的EAC在一个单一的机构超过30年的时间。资料的人口统计学，临床表现，治疗策略，和结果，以及ACC的病理特征，进行了审查和analyzed.Results：男性与女性的比例为1：3，平均患者年龄为55.9岁。最常见的临床表现是耳痛（75%）。10例患者接受了手术治疗，其中5例患者行乳突根治术，3例患者行广泛切除术，2例患者行侧颞骨切除术。在不完全切除的情况下进行辅助放射治疗或同步放化疗（CCRT）。2例患者接受非手术治疗：1例接受放疗，另1例接受CCRT。显微镜下神经浸润与耳痛或组织学亚型无关。平均随访时间为84.6个月。33%的患者发生局部复发。四分之一的患者有远处转移，所有患者都有肺转移。5年生存率为82.5%。结论：对于伴有耳痛和包块的EAC患者，尤其是中年女性患者，应将其纳入EAC ACC的鉴别诊断。耳痛可能与神经周侵犯或组织学亚型无关。肺是EAC ACC患者最常见的远处转移部位，进一步的研究应确定这种罕见恶性肿瘤的最佳治疗方案。
Background: This study reviewed the clinical manifestations, pathological findings, and treatment outcomes of adenoid cystic carcinoma (ACC) in the external auditory canal (EAC).Methods: This was a retrospective review of 12 patients with a diagnosis of ACC in the EAC seen in a single institution over a 30-year period. Data on the demographics, clinical presentation, treatment strategy, and outcome, as well as the pathological features of ACC, were reviewed and analyzed.Results: The male-to-female ratio was 1:3 and the mean patient age was 55.9 years. The most common clinical presentation was otalgia (75%). Ten patients underwent surgical interventions, including radical mastoidectomy in five patients, wide excision in three, and lateral temporal bone resection in two. Adjuvant radiotherapy or concurrent chemoradiotherapy (CCRT) was performed in case of incomplete resection. Two patients underwent non-surgical treatments: radiotherapy in one and CCRT in the other. Microscopic perineural invasion was not associated with otalgia or histological subtype. The mean follow-up period was 84.6 months. Local recurrence occurred in 33% of patients. One-quarter of patients had distant metastasis, and all had lung metastasis. The 5-year overall survival rate for these patients was 82.5%.Conclusion: EAC ACC should be included in the differential diagnosis when a patient presents with otalgia and a mass in EAC for more than 6 months, particularly if the patient is a middle-aged female. Otalgia might not be associated with perineural invasion or histological subtype. The lung is the most common site of distant metastasis in patients with EAC ACC. Further studies should determine the optimal treatment protocol for this rare malignancy.