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      Metástasis sacra de un carcinoma de células acinares de bajo grado de glándula parótida Translated title: Sacral metastasis of a low-grade acinar cell carcinoma of the parotid gland

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          Abstract

          RESUMEN El carcinoma de células acinares es una neoplasia de glándulas salivales poco común que generalmente cursa de manera indolente. La mayoría de los casos se presentan en las glándulas salivales mayores, principalmente la glándula parótida. Generalmente son neoplasias de bajo grado con una tasa de en torno al 20 % de recidivas locales, y una tasa de metástasis de alrededor del 10 %, que pueden aparecer muchos años después del diagnóstico del tumor original. Las localizaciones más frecuentes de metástasis son los ganglios linfáticos cervicales, el hígado y los pulmones. Las metástasis óseas a nivel de la columna vertebral son extremadamente raras. En este artículo presentamos el caso de un paciente con un carcinoma de células acinares de glándula parótida derecha, que presentó metástasis a distancia a nivel del sacro 8 años después del tratamiento quirúrgico del tumor inicial.

          Translated abstract

          ABSTRACT Acinic cell carcinoma is an uncommon salivary gland neoplasm that is generally indolent. Most cases arise in the major salivary glands, mainly the parotid. Generally, they are low-grade neoplasms with a 20 % rate of local recurrences and about 10 % rate of metastases which may appear many years after the initial presentation of the original tumour. The most frequent locations of the metastasis are the cervical lymph nodes, liver, and lungs. Metastases at the level of the spine are extremely rare. In this article, we report a case of a patient with an acinic cell carcinoma of the right parotid gland, who presented a distant metastasis at the level of the sacrum 8 years after surgical treatment of the initial tumour.

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          Most cited references9

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          Clinical and pathologic prognostic features in acinic cell carcinoma of the parotid gland.

          To the authors' knowledge, the indications for adjuvant treatment in acinic cell carcinoma (AciCC) of the parotid gland have not been elucidated to date. The aim of the current study was to determine patterns of failure and adverse prognostic features. Between March of 1989 and August of 2006, 35 patients underwent surgery at Memorial Sloan-Kettering Cancer Center for AciCC of the parotid gland and had their clinical and pathologic features retrospectively analyzed at the primary site. All cases were reviewed by 2 head and neck pathologists. Five-year estimates of survival outcomes were performed, followed by univariate analysis of potential prognostic features. The T classifications were as follows: T1 in 46% of patients, T2 in 23% of patients, T3 in 18% of patients, and T4 in 9% of patients. Three patients had cervical lymph node involvement. All patients underwent surgery as their primary treatment. Approximately 63% of patients (n = 22) received radiation treatment. The median follow-up time for surviving patients was 59.9 months. Five-year estimates of disease-free survival (DFS), overall survival (OS), and local control were 85%, 90%, and 90%, respectively. Of the clinical variables tested, clinical extracapsular extension (ECE), facial nerve sacrifice, and lymph node involvement were found to be significantly associated with a detriment in DFS and OS (P 2 mitoses per 10 high-power fields (HPF), atypical mitosis, vascular invasion, perineural invasion, pleomorphism, and necrosis were associated with adverse DFS (P 2 mitoses/10 HPF) and/or tumor necrosis, high-grade carcinomas had a significantly lower DFS and OS (P = .001). AciCC had a low treatment failure rate, and a large number of patients could be considered candidates for surgery only. A histologic grading system was devised to help stratify patients for adjuvant treatment.
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            Demographic trends and disease-specific survival in salivary acinic cell carcinoma: an analysis of 1129 cases.

            Acinic cell carcinoma (AciCC) is a rare salivary gland malignancy that most commonly arises in the parotid gland. Characteristics of AciCC are slow growth and a long clinical course. As a rare tumor, population-based studies are limited. We analyzed the incidence and survival for AciCC using a national population-based database.
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              Diagnosis and management of parotid carcinoma with a special focus on recent advances in molecular biology.

              Recent progress in diagnosis, treatment, prognosis, and outcome of parotid cancer is reviewed. Modern imaging allows evaluation of the anatomical extent of the cancer and its relationship to the facial nerve, and the World Health Organization (WHO) Histological Classification facilitates accurate, consistent diagnosis. Surgery remains the treatment of choice with preservation of a functioning facial nerve. Resection of the facial nerve should only be undertaken when there is clinical evidence of nerve dysfunction. The NO neck should be treated in advanced-stage and high-grade cancers, but the choice between elective surgery and elective irradiation remains controversial. Low-stage, low-grade tumors can generally be cured by surgery alone. Postoperative radiotherapy improves locoregional control in all other tumor stages and grades. Currently, the diagnostic and therapeutic approach to parotid cancer offer few options for a class of neoplasms that has many subtypes each with a unique molecular background and variable clinical behavior. Nonetheless, this approach results in a satisfactory locoregional cancer control, making distant metastasis the most frequent cause for treatment failure. At present, systemic treatment for distant failure is disappointing, although recent progress in molecular biology has suggested that adding targeted therapy should achieve tumor response or stabilization. Although disease control remains variable, the prognosis of individual patients can be increasingly accurately predicted by multivariate analysis.
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                Author and article information

                Journal
                maxi
                Revista Española de Cirugía Oral y Maxilofacial
                Rev Esp Cirug Oral y Maxilofac
                Sociedad Española de Cirugía Oral y Maxilofacial y de Cabeza y Cuello (Madrid, Madrid, Spain )
                1130-0558
                2173-9161
                June 2021
                : 43
                : 2
                : 63-66
                Affiliations
                [3] Madrid orgnameHospital Universitario La Paz orgdiv1Departamento de Cirugía Ortopédica y Traumatología España
                [2] Madrid orgnameHospital Universitario La Paz orgdiv1Departamento de Anatomía Patológica España
                [1] Madrid orgnameHospital Universitario La Paz orgdiv1Departamento de Cirugía Oral y Maxilofacial España
                [4] Madrid orgnameHospital Universitario La Paz España
                Article
                S1130-05582021000200063 S1130-0558(21)04300200063
                10.20986/recom.2021.1228/2020
                64729313-3d20-41d5-a9a1-ca357fefd857

                This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

                History
                : 02 February 2021
                : 21 November 2020
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 9, Pages: 4
                Product

                SciELO Spain

                Categories
                Casos Clínicos

                metastasis,parotid gland,salivary gland cancer,Acinic cell carcinoma,metástasis,glándula parótida,cáncer glándula salivar,Carcinoma de células acinares

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