title: Adenoid cystic carcinoma of the maxillary sinus with gradual histologic transformation to high-grade adenocarcinoma: a comparative report with dedifferentiated carcinoma.
abstract: We report a unique case of adenoid cystic carcinoma (ACC) of the maxillary sinus, with gradual histologic transformation from lower-grade ACC (cribriform and tubular types) to high-grade adenocarcinoma (HGA) showing a sequential histologic spectrum via solid-type ACC. A 74-year-old man presented with swelling and mild pain of the right cheek. CT scan showed a mass measuring approximately 4 cm, with marked bone destruction in the right maxillary sinus. A surgically resected specimen revealed that the tumor was comprised of three different components: HGA and solid-type ACC in the central portion and lower-grade ACC in the periphery. The tumor was discriminated from a dedifferentiated carcinoma or hybrid tumor. Autopsy specimens also demonstrated both solid-type ACC and HGA components in the lung and spleen. Immunohistochemically, positive staining of p53 protein was detected on both solid-type ACC and HGA cells, but cyclin D1 and HER2/neu was only seen in HGA cells. Solid-type ACC cells were immunoreactive for CD117 (c-kit), but lower-grade ACC and HGA cells were negative. This case suggests that the overexpression of CD117, p53 protein, cyclin D1, and HER2/neu might be involved in the progression from lower-grade ACC to solid-type ACC and HGA.
authors.affiliation: Department of Pathophysiological and Experimental Pathology, Kanazawa Medical University, 1-1 Daigaku, Uchinada, Kahoku-gun, Ishikawa 920-0293, Japan. sato-k@kanazawa-med.ac.jp
authors.forename: Katsuaki
authors.initials: K
authors.lastname: Sato
authors.forename: Yoshimichi
authors.initials: Y
authors.lastname: Ueda
authors.forename: Aya
authors.initials: A
authors.lastname: Sakurai
authors.forename: Yoshimaro
authors.initials: Y
authors.lastname: Ishikawa
authors.forename: Sachiko
authors.initials: S
authors.lastname: Kaji
authors.forename: Takayuki
authors.initials: T
authors.lastname: Nojima
authors.forename: Shogo
authors.initials: S
authors.lastname: Katsuda
mesh_terms: D000199:Actins / Q000032:analysis; D000230:Adenocarcinoma / Q000378:metabolism / Q000473:pathology*; D000368:Aged; D002277:Carcinoma / Q000378:metabolism / Q000473:pathology; D003528:Carcinoma, Adenoid Cystic / Q000378:metabolism / Q000473:pathology*; D018450:Disease Progression; D017809:Fatal Outcome; D006801:Humans; D007150:Immunohistochemistry; D007633:Keratins / Q000032:analysis; D008113:Liver Neoplasms / Q000556:secondary; D008175:Lung Neoplasms / Q000556:secondary; D008297:Male; D008444:Maxillary Sinus Neoplasms / Q000378:metabolism / Q000473:pathology*; D009130:Muscle, Smooth / Q000737:chemistry; D009418:S100 Proteins / Q000032:analysis; D016159:Tumor Suppressor Protein p53 / Q000032:analysis
chemical_list: D000199:Actins; D009418:S100 Proteins; D016159:Tumor Suppressor Protein p53; D007633:Keratins