Multiple osteolytic lesions of intraosseous adenoid cystic carcinoma in the mandible mimicking apical periodontitis.
OBJECTIVE
Adenoid cystic carcinoma (ACC) is a relatively rare epithelial tumour of the salivary glands in the maxillofacial region. About 40-60% of the patients develop distant metastases, which have been documented most commonly in the lung but also in brain, bone, liver, thyroid, spleen and pancreatic gland.


CONCLUSIONS
A 55-year-old women with intraosseous ACC in the mandible mimicking apical periodontitis following curative resection and radiotherapy is presented. Three years later, multiple lung metastases were observed followed by chemotherapy. Five years after curative resection, the patient presented simultaneously with new expansive soft tissue in the pancreas and mammary gland as well as in the kidney found to be metastatic ACC. No case has been reported to date on the manifestation of distant metastases of intraosseous ACC in the breast and the kidney as described by these observations. Metastatic mammary gland ACC stained positive for epithelial growth factor receptor (EGFR) but was negative for HER-2/neu and Cyclooxygenase-2 (COX-2) expression.
Department of Oral and Maxillofacial Plastic Surgery, Tübingen University Hospital, Tübingen, Germany. martin.grimm@med.uni-tuebingen.de
M
M
Grimm
T
T
Henopp
S
S
Hoefert
F
F
Schaefer
S
S
Kluba
M
M
Krimmel
S
S
Reinert
D016301:Alveolar Bone Loss / Q000175:diagnosis* / Q000209:etiology; D001943:Breast Neoplasms / Q000556:secondary; D003528:Carcinoma, Adenoid Cystic / Q000473:pathology / Q000556:secondary* / Q000601:surgery; D051546:Cyclooxygenase 2 / Q000096:biosynthesis; D003937:Diagnosis, Differential; D003951:Diagnostic Errors; D004815:Epidermal Growth Factor / Q000737:chemistry; D005260:Female; D006801:Humans; D006931:Hyperbaric Oxygenation; D007680:Kidney Neoplasms / Q000556:secondary; D008339:Mandibular Neoplasms / Q000473:pathology* / Q000601:surgery; D008875:Middle Aged; D010019:Osteomyelitis / Q000175:diagnosis / Q000628:therapy; D010190:Pancreatic Neoplasms / Q000556:secondary; D010485:Periapical Periodontitis / Q000175:diagnosis*; D018719:Erb-b2 Receptor Tyrosine Kinases / Q000032:analysis; D012468:Salivary Gland Neoplasms / Q000473:pathology* / Q000601:surgery
D051546:Cyclooxygenase 2; D004815:Epidermal Growth Factor; D018719:Erb-b2 Receptor Tyrosine Kinases