title: Recurrent adenoid cystic carcinoma in the liver: a repeated laparoscopic surgical approach.
abstract: Adenoid cystic carcinoma (ACC) is characterized by a particularly aggressive behavior even many years after resection of primary tumor. The evolution of metastasis dramatically affects the final outcome but resection should always be evaluated. Herein is described a case of aggressive ACC of the parotid gland in a 30-year-old female. She developed local recurrence and lung metastases; then, she also developed two liver metastasis 112 and 132 months after the resection of the primitive cancer of the parotid gland. Both lesions were successfully managed by a laparoscopic approach. Intra-abdominal adhesions after the first surgery were mild, allowing an easier access for the second laparoscopic liver resection. At 1 year follow-up, the patient is liver disease free with a stable lung disease. To our knowledge, this is the first report of a double laparoscopic liver resection for parotid gland's ACC metachronous metastases. Patients with resected ACC need a strict and lifelong follow-up after the resection of the primitive cancer. Also for ACC, a laparoscopic approach to liver metastasis should always be considered as a viable alternative to open surgery. In our experience of over 90 cases, laparoscopic surgery causes less adhesions, allowing an easier approach for repeated resections.
authors.affiliation: Hepatobiliary Surgery and Liver Transplant Unit, "A. Cardarelli" Hospital, Via A. Cardarelli, 9, 80131, Naples, Italy. scuderi.enzo@gmail.com
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Scuderi
authors.forename: Antonio
authors.initials: A
authors.lastname: Ceriello
authors.forename: Marina
authors.initials: M
authors.lastname: Romano
authors.forename: Carla
authors.initials: C
authors.lastname: Migliaccio
authors.forename: Giuseppina
authors.initials: G
authors.lastname: Marino Marsilia
authors.forename: Fulvio
authors.initials: F
authors.lastname: Calise
mesh_terms: D000328:Adult; D003528:Carcinoma, Adenoid Cystic / Q000473:pathology / Q000556:secondary / Q000601:surgery*; D005260:Female; D006801:Humans; D010535:Laparoscopy; D008113:Liver Neoplasms / Q000556:secondary / Q000601:surgery*; D009364:Neoplasm Recurrence, Local / Q000601:surgery*; D010307:Parotid Neoplasms / Q000473:pathology / Q000601:surgery; D012086:Reoperation