The law of paired cases on the example of adenocystic cancer of salivary glands tissue with multicentric growth of different locations

Abstract

Adenoid cystic cancer of the salivary glands is characterized by recurrent and/or metastatic course. Compared with other histological types of salivary gland cancer, it usually has a more latent clinical course with a low incidence of spread to regional lymph nodes. However, after removal of the primary tumor, local and distant relapses are quite common. In addition, the presence of prognostic factors such as metastases in the lymph nodes of the neck, low degree of tumor differentiation, perineural and lymphovascular invasion contributes to an increase in the frequency of distant metastasis with a poor prognosis.

Cases of atypical arrangement of salivary gland tissues with extranodal heterotopia are rare. In the head and neck region, different localizations of heterotopia of salivary gland tissues have been described, but the pterygopalatine fossa was not mentioned in the available sources. The difficulty of histological diagnosis when verifying heterotopia of the salivary glands may be due to the phenomena of chronic inflammation, lymphoid infiltration, tissue fibromatosis and the development of metaplasia. The rare occurrence of heterotopia of the salivary glands, the difficulties of its diagnosis and the lack of a unified approach to surgical treatment require consideration of each individually identified case.

The law of paired cases (also known as the law of series) is implemented in the interpretation of the presented clinical cases, when the identification of individual extraorgan foci of adenoid cystic cancer of the pterygopalatine space may be associated with a rare extranodal heterotopia of salivary gland tissue. The primary multiplicity of malignant lesions of the major salivary glands and heterotopia of salivary gland tissue can be both synchronous and metachronous. Adenoid cystic cancer of the pterygomaxillary fossa, as a component of multicentric growth of various localizations, clinically confirmed the recurrent nature of the course, the tendency to distant metastasis and generalization of the malignant process.

Keywords

adenoid cystic carcinoma / cylindroma / salivary glands / multicentric growth / tissue / heterotopia / pterygopalatine fossa

References

[1] MirVracha [Internet]. Law of series [cited 25 Sep 2023]. Available from: https://mirvracha.ru/forum/latest/zakon_parnykh_sluchaev_1-16-11-2021 (In Russ)

[2] Портал Мир врача [интернет]. Закон парных случаев [дата обращения: 25.09.2023]. Доступ по ссылке: https://mirvracha.ru/forum/latest/zakon_parnykh_sluchaev_1-16-11-2021

[3] Argumenty i Fakty [Internet]. What is the law of series [cited 25 Sept 2023]. Available from: https://aif.ru/society/science/chto_takoe_zakon_parnyh_sluchaev (In Russ)

[4] Еженедельник Аргументы и факты [интернет]. Что такое закон парных случаев [дата обращения: 25.09.2023]. Доступ по ссылке: https://aif.ru/society/science/chto_takoe_zakon_parnyh_sluchaev

[5] Blotsky AA, Anipenko VV. Salivary gland heterotopia in the lingual tonsil. Amur Medical Journal. 2019;(1(25)):72–76. doi: 10.22448/AMJ.2019.1.72-76

[6] Блоцкий А.А., Антипенко В.В. Гетеротопия слюнных желёз в язычную миндалину // Амурский медицинский журнал. 2019. № 1(25). С. 72–76. doi: 10.22448/AMJ.2019.1.72-76

[7] Kostyaeva MG, Eremina IZ, Kastyro IV. Morphology and physiology of the salivary glands. Head and neck. Russian Journal. 2022;10(3):81–87. doi: 10.25792/HN.2022.10.3.81-87

[8] Костяева М.Г., Еремина И.З., Кастыро И.В. Морфология и физиология слюнных желёз // Голова и шея. 2022. Т. 10, № 3. С. 81–87. doi: 10.25792/HN.2022.10.3.81-87

[9] Gribova OV, Novikov VA, Choynzonov EL, Startseva ZhA. Prognostic factors and current approaches to the treatment of salivary glands malignancies. Head and neck. Russian Journal. 2018;6(4):58–64. doi: 10.25792/HN.2018.6.4.58–64

[10] Грибова О.В., Новиков В.А., Чойнзонов Е.Л., Старцева Ж.А. Прогностические факторы и современные подходы к лечению злокачественных опухолей слюнных желёз // Голова и шея. 2018. Т. 6, № 4. С. 58–64. doi: 10.25792/HN.2018.6.4.58–64

[11] Kozhanov LG, Kozhanov AL, Romanova ES. Current aspects of the diagnosis and treatment of adenoid cystic carcinoma of the trachea and larynx: a literature review. Head and Neck Tumors (HNT). 2022;12(1):99–106. doi: 10.17650/2222-1468-2022-12-1-99-106

[12] Кожанов Л.Г., Кожанов А.Л., Романова Е.С. Современные аспекты диагностики и лечения аденокистозного рака трахеи и гортани: обзор литературы // Опухоли головы и шеи. 2022. Т. 12, № 1. С. 99–106. doi: 10.17650/2222-1468-2022-12-1-99-106

[13] Saprina OA, Kropotov MA, Tulyandin SA, et al. Current trends in the treatment of recurrent adenocystic cancer of the salivary glands: case report. Head and Neck Tumors (HNT). 2022;12(4):109–115. doi: 10.17650/2222-1468-2022-12-4-109-115

[14] Саприна О.А., Кропотов М.А., Тюляндин С.А., и др. Современные тенденции в лечении рецидивирующего аденокистозного рака слюнных желез: клинический случай // Опухоли головы и шеи. 2022. Т. 12, № 4. С. 109–115. doi: 10.17650/2222-1468-2022-12-4-109-115

[15] Kutukova SI, Imyanitov EN, Raskin GA, et al. Survival of patients with salivary gland malignancies depending on the molecular profile of the tumor. Head and Neck Tumors (HNT). 2020;10(3):65–71. doi: 10.17650/2222-1468-2020-10-3-65-71

[16] Кутукова С.И., Имянитов Е.Н., Раскин Г.А., и др. Выживаемость пациентов со злокачественными новообразованиями слюнных желёз в зависимости от молекулярного профиля опухоли // Опухоли головы и шеи. 2020. Т. 10, № 3. С. 65–71. doi: 10.17650/2222-1468-2020-10-3-65-71

[17] Kropotov MA, Yakovleva LP, Zhukova LG, et al. Multiple primary malignant neoplasms of the mouth and oropharynx. Head and Neck Tumors (HNT). 2022;12(2):55–62. doi: 10.17650/2222-1468-2022-12-2-55-62

[18] Кропотов М.А., Яковлева Л.П., Жукова Л.Г., и др. Первичномножественные злокачественные новообразования полости рта и ротоглотки // Опухоли головы и шеи. 2022. Т. 12, № 2. С. 55–62. doi: 10.17650/2222146820221225562

[19] STOMWEB [Internet]. Structure of the pterygopalatine fossa [cited 25 Sep 2023]. Available from: https://stomweb.ru/articles/krylovidno-nebnaya-yamka (In Russ)

[20] Образовательная платформа STOMWEB [интернет]. Строение крыловидно-нёбной ямки [дата обращения: 25 Sep 2023]. Доступ по ссылке: https://stomweb.ru/articles/krylovidno-nebnaya-yamka

[21] MedUniver.com [Internet]. Anatomy of the pterygopalatine fossa and its contents [cited 25 Sep 2023]. Available from: https://meduniver.com/Medical/otorinolaringologia_bolezni_lor_organov/anatomia_krilonebnoi_iamki.html (In Russ)

[22] Медицинский портал МедУнивер — MedUniver.com [интернет]. Анатомия крылонёбной ямки и её содержимое [дата обращения: 25.09.2023]. Доступ по ссылке: https://meduniver.com/Medical/otorinolaringologia_bolezni_lor_organov/anatomia_krilonebnoi_iamki.html

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