ADENOID CYSTIC CARCINOMA : UNUSUAL CAUSE OF GLOBUS PHARYNGEUS
DR SWATI TANDON1, DR.VASUN BATRA2, DR. ISHWAR SINGH3
1M.S(ENT),DNB(ENT) , REGISTRAR ENT , MAULANA AZAD MEDICAL COLLEGE, NEW DELHI,INDIA
2MBBS, RESIDENT,ENT. MAULANA AZAD MEDICAL COLLEGE, NEW DELHI,INDIA
3MS(ENT), PROFESSOR,ENT. MAULANA AZAD MEDICAL COLLEGE, NEW DELHI,INDIA
Email - Drswatitandon86@gmail.com, vasun58@gmail.com, Drisingh62@gmail.com Abstract
Adenoid cystic carcinoma comprises about 10% of salivary gland malignancies. Most of them arise in minor salivary glands. It is known for its late presentation, perineural invasion and local recurrence. Adenoid cystic carcinoma of base tongue is very rare. We report a rare case of adenoid cystic carcinoma of base tongue in a female who presented as globus pharyngeus.
Introduction
Adenoid cystic carcinoma (ACC) is a malignant tumor presenting 1-2% of all head and neck tumours. They generally present as slow growing masses. The tumour has marked propensity for neural invasion. In oral cavity, palate is the most common site followed by tongue. The most common site of distant metastasis is lungs. The treatment of choice is surgery followed by radiotherapy. We report a rare case of ACC of base tongue in a 50 yr old female managed by surgery and radiotherapy.
Case report
A 50 year old female presented with chief complaint of foreign body sensation in throat for 3 months. There were no complaints of
The physical Assessment Findings: The patient’s head, eyes, ears and nose are normal, however there is white patches on the buccal mucosa. The lymph nodes and carotid bruits are absent. Her heart beat at a regular rate and rhythm without murmur. Her lungs sound is diminished to auscultation with end expiratory wheezes, and dull percussion to the right lower lobe. Her anterior-posterior diameter of the chest wall is also increased. Her abdomen is benign. She has strong pedal pulses to all extremities without edema.
A 40-year-old woman comes to the clinic with a history of worsening nasal congestion and recurrent sinus infections. She had been healthy until about 1 year ago when she first noticed persistent rhinorrhea, sneezing, and stuffiness. She noted that when she went on a 2-week vacation to Mexico, her rhinorrhea disappeared, only to return when she came home again. She has lived in the same house for the past 5 years along with her husband and one child. They have had a dog for 4 years and a cat for 1 year. On physical examination, she has boggy, swollen nasal turbinates and a cobblestone appearance of her posterior pharynx.
Patient is a 60-year-old Latin American female, who presents with her husband for evaluation of some spells. She seems to have two different things going on. She did report intermittent episodes of feeling of weakness with blurred vision, diffuse paresthesias and a sensation she is about to pass out or the sensation of before undergoing generalized surgery, feeling like she is being sucked down. There is no loss of consciousness with this. She is unable to give any further history, except these events have been going on for about a month. They are almost daily. She does note they happen after eating, at which point, she will fall asleep easily. Otherwise, she denies any loss of consciousness,
Invasive lobular carcinoma is a medical term that is also known as “Infiltrating Lobular Carcinoma.” Lobular carcinoma is cancer within the glands and and lobules. Invasive lobular carcinoma is when the cancer passes the wall of lobules and glands and spreads to the tissue around the breast. This specific cancer is the second most common type of breast cancer woman are diagnosed with. Both women and men can get lobular carcinoma. Normal mens breast don’’t contain lobules (milk ducts) therefore it is very rare for men to be diagnosed.
Throat. Pharynx mucosa pink, without lesions or exudate. Soft palate and uvula rise at midline. Tonsils not visible. Gag reflex intact.
History of Present Illness: Per patient report, he was in his usual state of good health until 2 days ago when he started feeling a throbbing throat pain. The pt denies pain in any other part of his body. The sore throat is al most constant and states feeling a throbbing sensation. Aggravating factors are swallowing and talking. The patient feels some short relief when he takes lozenges or eats something cold. Pt states awakening at night due to the throbbing throat pain. Currently, the pain level is 7/10 in a numeric scale (0-10). Denies any other associated symptoms such as headache, fever, chills, drooling, problem swallowing, hoarseness, sneezing, runny
The mandibular tumors arise more frequently in the posterior body and in the horizontal ramus whereas the maxillary tumors occur in the alveolar ridge, the sinus floor and the palate. (2, 5-7) Symptoms usually include painful swelling in the area and loosening of teeth, although paresthesia, nasal obstruction and ophthalmic complications such as proptosis may be noted. The radiographic finding varies from radiopaque , mixed radiopaque - radiolucent or entirely radiolucent lesion with irregular border. Widening of the periodontal ligament space and enlargement of the mandibular canal also widely described as important radiographic features. The radiographic feature of OS are not patogonomonic.(2-4, 6, 8, 9) Thus incisional biopsy and histopathological analysis are essential for the final diagnosis and further treatment. Depending on the relative amounts of osteoid ,cartilage or collagen fibers produced by the tumor, Many pathologists subclassify OSs into the three types: osteoblastic, chondroblastic and fibroblastic (3, 4, 6, 7, 9). This article reports a case of chondroblastic OS of maxilla. The aim of this case was to draw attention to the possibility of diagnosing this tumor based on its clinical and radiographical characteristic before its confirmation by
Lymphatic malformations (LMs) are benign cystic lesions which, while rare, often affect the pediatric age group. LMs can be macrocystic, microcystic or a combination of the two, and frequently involve the head and neck regions. Ultrasound is useful in the prenatal detection of LMs; however, these lesions can be missed. This case study outlines the incidental finding of a sublingual cyst during a third trimester ultrasound. Postnatal magnetic resonance imaging (MRI) demonstrated a lesion with peripheral enhancement on the anterior and inferior aspect of the tongue, consistent with a lymphatic malformation. While intervention was not required for the patient, this report outlines the risks, including airway obstruction, and possible treatments for LMs. Finally, we explore the impact of sonography in the prenatal detection of oral cysts, and discuss how sonographers might be able to increase the likelihood of their discovery.
Enlarged adenoids are when your adenoids are larger than normal. Your adenoids are in the back of your nose and are part of your body’s natural defense (immune) system.
No known allergies, no sinus, tenderness, no epistaxis, no bleeding gums, patient has partial dentures, one dental carrier noted, tongue is slightly coated, no swelling, lumps or tenderness noted in throat,
Oral squamous cell carcinomas are rapid in growth and are not due to sunlight exposure. Refusal to eat due to the tumors on the tongue and/or surrounding gums, drooling, bad breath, and swollen lymph nodes, are symptoms. Oral carcinoma’s needs to be diagnosed early. If not, the prognoses is not good and death is eminent.
patient was not having any pain or significant discomfort in the area. The throat was
Of 37 cases, 9 cases occurred in major salivary glands, with eight occurrences in the parotid region - 1 PA, 1 Adenolymphoma & 6 Acinic cell adenocarcinoma (AcADCC) and one in submandibular region- 1 Polymorphous low grade adenocarcinoma (PLGA). Of 37 cases, 28 cases occurred in minor salivary glands, with palate being the most commonly affected site by both benign (63.63%) and malignant tumors (58%).
Cardiac: Regular rhythm without murmur, normal S1and S2. One plus edema to bilateral lower extremities. Capillary refills are presents and carotid bruits are absent.
The literature review was detailed explaining the etiology diagnosis and treatment of the disease however limited literature references were mentioned to support the conclusion that, Oral cavity lesions can be the first sign of relapse or succession of myeloma.1