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Surgical treatment of carinal tumors that extend into the lobar bronchus is a procedure that challenges thoracic surgeons. There is no consensus on the suitable technique for a safe anastomosis in lobar lung resection with carina. The preferred Barclay technique has a high rate of anastomosis-related complications. Although a lobe-sparing end-to-end anastomosis technique has been previously described, the double-barrel method can be applied as an alternative technique. We present a case where we performed double-barrel anastomosis and neo-carina formation after tracheal sleeve right upper lobectomy. [ABSTRACT FROM AUTHOR]

Adenoid cystic carcinoma (ACC) grows slowly and is characterised by potential recurrence and metastasis to distant organs. This study aimed to evaluate the risk factors for locoregional recurrence (LRR) and distant metastasis in patients with ACC of the external auditory canal (EAC). Demographic, pathological, therapeutic and survival data of 143 patients with EAC ACC were reviewed in this study. Univariate and multivariate Cox proportional hazard regression analyses were carried out to determine the risk factors for LRR and distant metastasis. Factors associated with overall survival after LRR and distant metastasis were also analysed. During a median follow-up of 49 months, 31 of 143 patients were observed with LRR and 34 developed distant metastasis. Bone invasion and histological subtype were independent risk factors for locoregional recurrence-free survival. T stage and LRR were independent risk factors for distant metastasis-free survival. Salvage surgery and adjuvant radiotherapy or chemoradiotherapy for LRR resulted in better survival, whereas extrapulmonary metastasis and LRR were associated with a higher risk of poor survival after distant metastasis. Patients with distant metastases, especially those with LRR, are at significant risk of poor prognosis. Our findings emphasise the importance of long-term regular follow-up and recommend surgical intervention with radiotherapy for recurrent EAC ACC. • Largest series of adenoid cystic carcinoma of the external auditory canal from a single centre. • Identify the risk factors influencing survival after the occurrence of locoregional recurrence and distant metastasis. • Emphasise the importance of long-term regular follow-up. • Provide guidance for treating physicians in terms of risk stratification and treatment strategies. [ABSTRACT FROM AUTHOR]

Background: Fine-needle aspiration cytology (FNAC) plays a role in the pre-operative diagnosis of salivary gland mass lesion. Salivary gland neoplasm accounts for 6% of all head and neck tumors. It is widely used safe and relatively non-traumatic procedure that can quickly provide important information. "The Milan system for reporting salivary gland cytopathology" (MSRSGC) was introduced, providing a guide for diagnosis and management according to the risk of malignancy (ROM) in different categories. Aims and Objectives: The objectives of the study are as follows: (1) To evaluate different types of salivary gland lesion in tertiary care center. (2) To see application of Milan system in the present scenario. Materials and Methods: A hospital-based and prospective study was conducted between March 2021 and September 2022 on all cases of salivary gland lesions who were referred for FNAC to the Department of Pathology at Netaji Subhash Chandra Bose Medical College Hospital in Jabalpur, Madhya Pradesh. In the present study, we categorize salivary gland cytopathology result as per Milan system (MSRSGC) and calculated diagnostic accuracy and ROM in each category of Milan system (MSRSGC). Results: Seventy seven cases distributed according to Milan category as follows: Non-diagnostic (ND) (2.59), non-neoplastic (NN) (29.33%), atypia of undetermined significance (AUS) (1.29%), 4a. Benign (29.87%), 4b. Salivary gland neoplasm of uncertain malignant potential (SUMP) (1.29%), suspicious of malignancy (SOM) (1.29%), and malignancy (10.38%). Out of 77 cases, histological follow-up was available in 27 cases and the ROM was calculated. The ROM for each category of the Milan system is as follows: ND (0%), NN (6.66%), AUS (100%), 4a. Benign (9.09%), 4b. SUMP (0%), SOM (100%), and Malignancy (100%). The sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy were 77.7%, 100%, 100%, 92.59%, and 94.11%. Conclusion: FNAC of the salivary gland lesions is a safe, minimum invasive, and reliable diagnostic procedure. The Milan system of reporting is a risk stratification system which can improve the overall effectiveness of reporting. [ABSTRACT FROM AUTHOR]

Upregulation of B-cell specific Moloney murine leukemia virus insertion site 1 (BMI-1) has been involved in the invasion, metastasis, and poor prognosis of many cancers. The aim of this study was to evaluate the levels and clinical significance of BMI-1 in saliva of patients with salivary adenoid cystic carcinoma (SACC), and to analyze biological function and mechanism of BMI-1 in the invasion and metastasis of SACC. The levels of BMI-1 in saliva and tumor tissues of SACC patients were determined. The correlation of salivary BMI-1 levels with clinicopathological parameters and clinical outcomes in patients with SACC was analyzed. Additionally, the effects of BMI-1 on wound-healing, transwell invasion, and epithelial-mesenchymal transition (EMT)-related protein expression in vitro as well as on tumorigenicity and experimental lung metastasis in vivo were investigated through exogenous overexpression and silencing of BMI-1 in SACC cells. BMI-1 levels increased in saliva and tumor tissues in SACC patients with invasion or metastasis. High salivary BMI-1 levels were correlated with poor TNM stage, poor overall survival, and disease-free survival. Exogenous expression of BMI-1 in SACC-83 promoted its migration and invasion, while silencing BMI-1 in SACC-LM inhibited its migration and invasion in vitro and suppressed tumorigenesis and lung metastasis in vivo. Furthermore, BMI-1 regulated the expression of EMT-related proteins in SACC. Our study shows that BMI-1 can serve as a valuable biomarker to identify tumor invasion and metastasis in SACC, predict its prognosis, and act as a promising therapeutic target for SACC. [ABSTRACT FROM AUTHOR]

Secretory carcinoma (SC) is a rare salivary gland tumor that featured by ETV6::NTRK3 gene fusion, and was included in the WHO Classification of Head and Neck Tumors since 2017. Nevertheless, the description of SCs by WHO is still vague. This study examined 18 SC cases by using both histomorphology and molecular pathology for diagnostic determination, especially immunohistochemical features of SCs. Based on WHO characteristics, 18 patients with SC admitted between 2001 and 2022 were included in this study. Main histomorphological patterns, FISH analyses of the ETV6::NTRK3 gene fusion, and immunohistochemical analyses of S100, mammaglobin, DOG1, ADFP, CA6 and Ki-67 were performed. Among the 18 SC patients, the median age of onset was 39.22 years. Grossly, the average tumor size in 2.96 cm with various texture from soft to tough. The majority patients were positive for S100, mammaglobin, and negative for DOG1, except for one patient negative for S100 (Case 18). All patients were positive for ADFP, and the majority patients were negative for CA6, except for Case 9. Two cases were found recurrence, and the tumor were found both in parotid gland with local invasion. Combined with the results of previous studies, we proposed that the combination of all five markers, S100, mammaglobin, DOG1, ADFP and CA6, could contribute more to differential diagnosis of SCs with other salivary carcinomas, especially with AciCC. The prognosis of SCs is optimistic in most cases, but larger patient cohort and long-term follow-up are still needed. [ABSTRACT FROM AUTHOR]

Adenomyoepithelioma (AME) is a rare, usually benign breast neoplasm with low potential for malignant transformation. Imaging features are nonspecific and overlap with other benign and malignant breast lesions. On mammography, AME most often presents as a mass, usually oval in shape, with variable reported margins. Less commonly, AME can present mammographically as an asymmetry or can be mammographically occult. Associated calcifications are uncommon. On US, AME is usually seen as a hypoechoic oval mass, but it can also manifest as a complex cystic and solid mass. On US, the majority of AME have noncircumscribed margins (indistinct, angular, or microlobulated). Internal vascularity is usually present, and posterior enhancement can be seen. Although there is limited literature on MRI features, the most frequent finding is an irregular mass with washout kinetics; T2 hyperintensity can be observed. These nonspecific and often suspicious imaging features usually merit biopsy. On histologic analysis, AME is characterized by a biphasic proliferation of myoepithelial and epithelial cells. Pathologic diagnosis can be difficult due to the variety of histologic features of AME and heterogeneity in these tumors, especially when sampling is limited, such as in core needle biopsies. Wide local surgical excision of AME is recommended due to potential for recurrence and malignant transformation. [ABSTRACT FROM AUTHOR]

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Adenoid cystic carcinoma (AdCC) metastasis to kidney is rare. We identified 10 patients with metastatic AdCC in multi-institutional collaboration. Core needle biopsy was the most common specimen (n = 6). Patients were predominately female (n = 7) with a median age of 48 years (35–62 years). The most common primary location of the AdCC was head and neck (n = 6, among them parotid gland = 4), followed by lung (n = 2), breast (n = 1), and vulva (n = 1). Median lapse between primary AdCC and renal metastasis was almost 13 years (154 months, range 1–336 months). Moreover, all but one patient had unilateral kidney metastasis. The majority of metastatic AdCC within the kidney demonstrated mixed growth patterns, frequently cribriform, and tubular morphology. Follow-up available for 8 patients showed 6 alive with disease and 2 died of disease (the longest survival was 4 years past the diagnosis of renal metastasis). A systematic literature review including 29 patients revealed that kidney metastasis by AdCC is usually a late event, is typically unilateral, and is usually composed of one to three foci, and thus has clinical features which mimic a primary renal tumor. [ABSTRACT FROM AUTHOR]

Primary tracheal tumors are very rare and the literature on this subject is limited. Due to their rarity and diversity, the provision of patient care in terms of optimal management poses a considerable challenge. There are no unequivocal guidelines concerning the treatment in patients with local or distant disease. The most common types of primary tracheal tumors are squamous cell carcinoma and adenoid cystic carcinoma. Squamous cell carcinoma of the trachea is 2-4 times more common in men than in women and develops primarily in the sixth and seventh decades of life. It is strongly associated with tobacco smoking. Adenoid cystic carcinoma of the trachea occurs with similar frequency in men and women, and is most common in the fourth and fifth decades of life. The etiology of this type is unknown, however it is not associated with tobacco smoking. Adenoid cystic carcinoma is characterized by submucosal and perineural spread. Treatment of patients with primary tracheal tumors requires a multidisciplinary approach. Optimal treatment of localized tumors is based on surgery or radiotherapy. If distant metastases are present the therapeutic palliative methods are: chemotherapy, palliative radiotherapy or palliative surgery. The prognosis of patients with primary tracheal tumors is determined by several factors. Histological diagnosis of adenoid cystic carcinoma, good performance status, and complete resection have been identified as favorable prognostic factors. Despite intensive treatment, the 5-year survival rate for primary tracheal tumors is not satisfactory. [ABSTRACT FROM AUTHOR]

Salivary gland adenoid cystic carcinoma (ACC) is a rare malignancy with limited treatment options. The development of novel therapies is hindered by a lack of preclinical models. We have generated ACC patient‐derived xenograft (PDX) lines that retain the physical and genetic properties of the original tumours, including the presence of the common MYB::NFIB or MYBL1::NFIB translocations. We have developed the conditions for the generation of both 2D and 3D tumour organoid patient‐derived ACC models that retain MYB expression and can be used for drug studies. Using these models, we show in vitro and in vivo sensitivity of ACC cells to the bromodomain degrader, dBET6. Molecular studies show a decrease in BRD4 and MYB protein levels and target gene expression with treatment. The most prominent effect of dBET6 on tumours in vivo was a change in the relative composition of ACC cell types expressing either myoepithelial or ductal markers. We show that dBET6 inhibits the progenitor function of ACC cells, particularly in the myoepithelial marker‐expressing population, revealing a cell‐type‐specific sensitivity. These studies uncover a novel mechanistic effect of bromodomain inhibitors on tumours and highlight the need to impact both cell‐type populations for more effective treatments in ACC patients. © 2023 The Authors. The Journal of Pathology published by John Wiley & Sons Ltd on behalf of The Pathological Society of Great Britain and Ireland. [ABSTRACT FROM AUTHOR]

Oncocytic mucoepidermoid carcinoma (OMEC) is an uncommon variant of mucoepidermoid carcinoma. Histopathologically, it is characterised by the predominance of cells with large polygonal morphology and with an abundance of eosinophilic granules. We present a rare case of OMEC manifested as painless palatal swelling in a 25-year-old young male. The overlying mucosa was normal in appearance, with no evidence of ulceration or discharge. Histopathology examination showed the presence of sheets of mucous and intermediate cells along with cystic areas of variable sizes and shapes. On high power magnification, oncocytes were evident, showing abundant granular eosinophilic cytoplasm with central dark round nuclei. Around 75-80% tumour cell population was composed of oncocytic cells. The predominant presence of oncocytes can present diagnostic difficulties to pathologists due to overlapping features with adenoid cystic carcinoma, oncocytoma, acinic cell carcinoma, Warthin's tumour, and other oncocyte tumours. Although the presence of oncocytes is a pathognomonic feature, the role of immunohistochemistry and genetic analysis in diagnosis is discussed in the present paper. Moreover, considering its behaviour as a low-grade MEC, it is prudent to avoid an aggressive treatment strategy and prevent unwarranted morbidity. We recommend prospective studies to better understand the factors that influence the prognosis of OMEC. [ABSTRACT FROM AUTHOR]

c-KIT is an important diagnostic marker in salivary gland tumours and is expressed in most adenoid cystic carcinomas. Histologically similar salivary gland tumours with variable immunohistochemical expression for c-KIT pose a challenge and make diagnostic reliability ambivalent. An electronic search was performed in MEDLINE by PubMed, Google Scholar, Scopus, Trip, Cochrane Library, and EMBASE up to 31 December 2023, without period restriction. The articles that investigated CD117 or c-KIT in salivary gland tumours were included for review. Sensitivity, specificity, and positive and negative predictive values of c-KIT immunohistochemical expressions were derived and subjected to meta-analysis using Open Meta analyst for Sierra software. The risk of bias in selected studies was analysed using the QUADAS-2 tool, and RevMan 5.4 was used to output the result. Forty-three articles were reviewed, and 2285 salivary gland cases were analysed. Adenoid cystic carcinoma had an overall expression of 84.9%. A similar expression was found in epimyoepithelial carcinoma (79.1%), lymphoepithelial carcinoma (75%), myoepithelial carcinoma (60.8%), monomorphic adenoma (94.1%), and pleomorphic adenoma (74.7%). The sensitivity, specificity, and positive and negative predictive values of c-KIT/CD117 for adenoid cystic carcinoma with other salivary gland tumours were 84.99%, 69.09%, 84.79%, and 69.41%, respectively. Current evidence shows that c-KIT, despite its sensitivity, is not specific and therefore cannot be a useful diagnostic marker for distinguishing adenoid cystic carcinoma from other salivary gland tumours. Further research on other salivary gland tumours that exhibit comparable expression is necessary to validate the diagnostic accuracy of c-KIT. [ABSTRACT FROM AUTHOR]

Adenoid cystic carcinoma (ACC) is a rare malignant tumor that mostly occurs in minor glands, especially in the palate. Intraosseous adenoid cystic carcinoma (IACC) is rarer. There is no clear conclusion on the clinical, radiologic and pathological characteristics of IACC because of few reported IACC cases, leading to insufficient understanding of IACC. We reviewed 52 previous reports of primary IACC (PIACC) and analyzed the clinical features of those patients involved, attempting to provide a better understanding of PIACC. Moreover, we present a case of primary PIACC and a case of recurrent IACC (RIACC). The two patients showed similarities in clinical and pathological results, along with slight differences in radiological and immunohistochemical results. The patient of case 1 seemed to display a worse prognosis, which can only be proved after long term follow-up. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to investigate the significance of parotid gland invasion in predicting distant metastasis of adenoid cystic carcinoma in the external auditory canal. Study Design: Single‐institution retrospective cohort study. Methods: A retrospective review of patients with adenoid cystic carcinoma of the external auditory canal who underwent surgery was performed. Information on patient demographics, parotid gland invasion, tumor stage, perineural invasion, lymphovascular invasion, and follow‐up data were collected and analyzed. Results: One hundred twenty‐nine patients were identified for review. Parotid gland invasion was noted in 45 patients (34.9%). Parotid gland invasion was significantly associated with tumor stage, perineural invasion, distant metastasis, and postoperative adjuvant therapy. Distant metastasis was noted in 30 patients (23.3%). Multivariate Cox proportional hazards analysis identified parotid gland invasion as an independent risk factor for predicting distant metastasis. The 5‐year distant metastasis‐free survival rate was 83.6% for patients without parotid gland invasion and 61.8% for patients with parotid gland invasion (p = 0.010). Conclusions: The parotid gland invasion rate is relatively high in adenoid cystic carcinoma of the external auditory canal and is significantly related to tumor stage. Parotid gland invasion is associated with worse distant metastasis‐free survival. Level of Evidence: 4 Laryngoscope, 134:419–425, 2024 [ABSTRACT FROM AUTHOR]

Background: Adenomyoepithelioma (AME) of the breast is an uncommon tumor characterized by the proliferation of ductal epithelial and myoepithelial cells with the heterogeneity. Although benign AME is relatively easy to differentiate from breast cancer by core needle biopsy (CNB) alone, a definitive diagnosis is often difficult. The imaging findings of AME are also variable, and there are particularly few reports about radiological features, including contrast-enhanced magnetic resonance imaging (MRI) and apparent diffusion coefficient (ADC) values in AME. Case presentation: We present two cases of benign AME. Case 1 is a 30-year-old woman with a history of asthma. The cystic tumor shows smooth borders, and the intracystic solid component is irregular in shape and high vascularity. The pathological findings of the tumor were benign on CNB. The MRI scan showed a decreased ADC value. Case 2 is a 60-year-old woman with only a history of arrhythmia. The tumor shows a lobulated mass with cystic space and coarse calcifications. The pathological findings of the tumor were found to be benign by CNB. Dynamic MRI scan showed a fast washout pattern with a decreased ADC value. Both patients underwent excisional biopsy to confirm the diagnosis, and the pathological diagnosis was benign AME in both cases. Conclusions: The AME of the breast has little specific imaging information, so it can be difficult to diagnose based on pathological findings of biopsy specimen. In our case, the ADC values were exceptionally low, contrary to previous reports. It is essential to carefully diagnose AME, considering the discrepancies in imaging findings observed in this case. [ABSTRACT FROM AUTHOR]

Aim of the Study: Epidermal growth factor receptor (EGFR) is a tyrosine kinase receptor of the Erb B family contributing to proliferation, invasion, and metastasis. EGFR overexpression is frequently associated with poor clinical outcome in malignant neoplasms. To evaluate and compare immunoexpression of EGFR in histopathological variants of oral squamous cell carcinoma (OSCC). To hypothesize the role of EGFR in determining biological behavior and prognostic course of histopathological variants of OSCC Materials and Methods: The study comprised a total of 40 cases including 10 cases each of Squamous cell carcinoma, Verrucous carcinoma, Adenosquamous cell carcinoma, and Adenoid squamous cell carcinoma. EGFR immunoexpression was observed qualitatively as low (1), moderate (2) and strong (3) and quantitatively as score 1 for <10%, 2 for 10%-50%, and 3 for >50% positive cells. The resulting data were analyzed using SPSS software version 19. Data have been expressed as mean and standard deviation. Differences between the different variables were analyzed using ANOVA, and Pearson's Chi-square. (p ≤ 0.05) Result: The study results revealed that the EFGR immunoexpression was highest in adenosquamous cell carcinoma followed by adenoid squamous cell carcinoma then conventional squamous cell carcinoma followed by lowest immunoexpression in verrucous carcinoma. The results were statistically significant. (p ≤ 0.05) Conclusion: Expression of EGFR could be established as a valuable biomarker with significant association in predicting aggressive potential and treatment response in various histopathological variants of OSCC. Further studies where EGFR could be linked to predictive indicators and tumor prognosis could be undertaken. [ABSTRACT FROM AUTHOR]

Aims: Malignant tumours of the lacrimal apparatus are rare and frequently show a poor prognosis, with no clear therapeutic standards. Characterisation of the genetic landscape of these rare tumours is sparse, and therefore therapeutics generally follow those of their common salivary gland counterparts. To further clarify the pathophysiology and discover potential therapeutic targets, we investigated the genetic landscape of eight tumours of the lacrimal apparatus. Methods and results: DNA and RNA sequencing were performed to identify genetic mutations and gene fusions. Immunohistochemistry, fluorescence in‐situ hybridisation and reverse transcription–polymerase chain reaction followed by Sanger sequencing were performed to confirm the identified molecular alterations. Genetic alterations were detected in six tumours. Among five adenoid cystic carcinomas (ACC), four had confirmed alterations of MYB or MYBL1 genes, including a MYB::NFIB fusion, a MYBL1::NFIB fusion, a MYB amplification and a novel NFIB::THSD7B fusion. Mutations in genes encoding epigenetic modifiers, as well as NOTCH1, FGFR2 and ATM mutations, were also identified in ACCs. A carcinoma ex pleomorphic adenoma showed TP53 and CIC mutations and an amplification of ERBB2. A transitional cell carcinoma was associated with HPV16 infection. No genetic alteration was found for one adenocarcinoma, not otherwise specified. Conclusions: Our study highlights the variety of molecular alterations associated with lacrimal system tumours and emphasises the importance of molecular testing in these tumours, which can reveal potentially targetable mutations. Our results also reinforce the hypothesis of a common physiopathology of all ACCs, regardless of their primary location. [ABSTRACT FROM AUTHOR]

Background and importance: Intramedullary spinal cord metastases (ISCMs) are rare and no cases of ISCM from an adenoid cystic carcinoma (ACC) of the external auditory canal (EAC) have been reported. Clinical presentation: We report a 54-year old man complaining backpain and worsening myelopathy. He had an ACC of the EAC resected years prior. A spinal MRI demonstrated a contrast-enhancing intramedullary lesion within the conus medullaris. The histopathological diagnosis of the patient was consistent with the patient's primary cancer. At 3 months follow-up, the neurological condition of the patient was unchanged. Conclusions: This is the first reported case of ISCM from a primary ACC of the EAC. [ABSTRACT FROM AUTHOR]

Background: Salivary gland tumours are rare cancers with variable course and prognosis. There is a paucity of data, especially for the advanced stages. Materials and methods: This is a retrospective analysis carried out in our institute. All patients seeking treatment for incurable advanced salivary gland tumours from October 2018 to September 2022 were included. Relevant clinical data were collected and appropriate statistical analysis was applied. Results: 30 patients were included in the analysis. The parotid gland was the most common site of origin (73%). Adenoid cystic carcinoma (ACC) and salivary duct carcinoma (SDC) were equally (37%) the most common pathological subtypes. The majority of patients were males (73%) and lungs (57%) were the most common site of metastases. On molecular analysis, SDC had high rates of androgen receptor (AR) (90%) and human epidermal growth factor receptor 2 (HER2) (55%) positivity. Mucoepidermoid carcinoma (MEC) had AR and HER2 positivity rates of 17% and 20%, respectively, while for ACC it was even lower. A variety of treatment regimens including hormonal therapy, anti-HER2 targeted therapy and chemotherapy were used in first-line treatment. With an overall response rate (ORR) of 10/21 (48%), only 9/21 (43%) went on to receive second-line treatment with an ORR of 4/9 (44%). The progression-free survival (PFS) with first-line treatment (PFS1) was a median of 5 months. The median PFS1 was worst for MEC. The median overall survival (OS) was 10 months. Median OS for ACC, SDC and MEC were 11, 10 and 7 months, respectively. At 24 months, ACC had much higher survival (50%) than others (10%) indicating a proportion of ACC with an indolent course. Conclusion: Our analysis highlights the variable disease biology of advanced salivary gland tumours and throws light on the various possible treatment targets and strategies. Molecular profiling and advancement in targeted therapies are expected to increase survival in this group of rare cancers. [ABSTRACT FROM AUTHOR]

Objectives TRPS1 is a new, sensitive marker for breast carcinoma (BC). Salivary glands and breasts are both exocrine glands; thus, their tumors may share similar morphology and immunophenotype. Among salivary gland–type BC, TRPS1 is reported to be positive in secretory carcinomas (SCs) but negative in acinic cell carcinomas (AciCCs) and most adenoid cystic carcinomas (AdCCs). A subset of salivary duct carcinomas (SDCs) is positive for TRPS1. Herein, we investigate TRPS1 immunohistochemical expression in salivary gland tumors (SGTs). Methods A retrospective search yielded 110 SGTs (97 primary and 13 metastatic). TRPS1 immunohistochemistry was scored as negative, low positive, intermediate positive, or strongly positive. Results TRPS1 was expressed in 78% (14/18) of pleomorphic adenoma (PA) cases but negative/low positive in all Warthin tumors (6/6 [100%]). In basal cell adenoma (BCA), TRPS1 expression was intermediate to strong (13/14 [92%]) in the stromal cells, whereas ductal or basal cells showed low expression. TRPS1 expression varied in malignant SGTs, with intermediate to strong staining in 100% (15/15) of AdCCs, 100% (5/5) of basal cell adenocarcinoma, 100% (3/3) of intraductal carcinoma, 89% (8/9) of polymorphous adenocarcinoma, and 89% (7/8) of SDCs; negative/low positive expression was observed in 100% (3/3) of SCs, 89% (8/9) of AciCCs, and 50% (3/3) of mucoepidermoid carcinomas. In addition, strong and intermediate TRPS1 expression was observed in metastatic SGT to the lungs, lymph nodes, and soft tissue. Conclusions Overall, TRPS1 is strongly expressed in PA as well as malignant and metastatic SGT. In addition, TRPS1 is positive in stromal cells of BCA but negative or low positive in ductal and basal cells. [ABSTRACT FROM AUTHOR]

Adenoid cystic carcinoma (ACC) is the most common malignant neoplasm involving the lacrimal glands, with high rates of recurrence and metastasis. During the pregnancy, reports of recurrence of ACC of the salivary glands and trachea have previously been published, but no lacrimal gland ACC recurrence has been reported. We present a 35-year-old woman with lacrimal gland ACC who was initially treated by surgical resection and adjunctive radiotherapy, but her cancer recurred during pregnancy, with rapid progression to cavernous sinuses and brain. Estrogen and progesterone receptors have been detected on lacrimal glands and ACCs of salivary glands. Thus, hormonal changes during pregnancy might contribute to the recurrence of ACC. However, the inherent invasive and recurrent nature of ACC could also account for the regrowth in this patient and further molecular studies can provide more accurate explanations. [ABSTRACT FROM AUTHOR]

Objective: High-grade parotid carcinoma generally has a poor prognosis, and the histological type is mucoepidermoid carcinoma (MEC), salivary duct carcinoma (SDC), carcinoma ex pleomorphic adenoma (CEPA), or adenoid cystic carcinoma (AdCC) in the majority of cases. Methods: During the 23-year period from September 1999 to December 2022, 250 patients with parotid carcinoma underwent initial treatment and had the histopathological type of their carcinoma. Retrospective study evaluated 111 MEC, SDC, CEPA, or AdCC cases among 134 patients with high-grade parotid carcinoma. We examined pathological and clinical features and prognosis, evaluated factors associated with recurrence, and performed immunohistological examinations. Results: Pathological and clinical features and factors associated with recurrence were different for each histological type. The 10-year disease-free survival rates were as follows: MEC, 34.9%; SDC, 22.6%; CEPA, 47.1%; and AdCC, 56.3%. Human epidermal growth factor receptor type-2 and androgen receptor were positive in 48% and 56% of patients with SDC, respectively, 38% and 25% of those with CEPA. Conclusion: Each histological type has its own pathological and clinical features, recurrence types, and tumor activities, suggesting that differentiating between high-grade parotid carcinomas according to histological type will improve diagnosis, and thus prognosis. [ABSTRACT FROM AUTHOR]

AIM- Male breast cancer is very rare, comprising 1% of all breast cancer with a male to female incidence ratio 1 : 100 . It comprises for < 0.2 % of all malignancies in men .. Rarity of disease and scarcity of data promoted us for retrospective clinico-pathological study, where to examine systemically regarding it’s epidemiology, risk factors, clinical assessment, genetics, pathology and molecular markers. MATERIALS AND METHODS – This study was conducted in Department of Surgery, VIMSAR, Sambalpur, Odisha over a period of fifteen month ( i.e. from August 2021 to October 2022 ), where male patients with aged between 30-75 years having clinical diagnosis of breast cancer were included. . The data regarding the incidence, presentation, histo-pathology, stage & grade of tumor, management and outcome were analysed. RESULTS – Out of 10 cases studied (which comprises 2.5% of all breast cancers seen in our department ), 8 (80%) cases had various risk factors for male breast carcinoma. Some cases were associated with multiple risk factors. Gynaecomastia (4 cases, 20% ) comprises at the top, which was followed by obesity and breast cyst (3 cases,15% each) . Mean age at presentation for invasive group and non-invasive group were 54 years ( range, 35 to 75 years ) and 57 years ( range, 50 to 65 years ) respectively. Maximum number of cases (i.e 8cases, 80%) corresponds to invasive ductal carcinoma, which was followed by papillo-tubular carcinoma and adenocystic carcinoma (1 case each) . ER+ve andPR+ve comprises 8 (80%) cases and 7 (70%) cases respectively . 5(50%) cases were presented with Stage –III, which was followed by Stage–II and Stage-I having 3 cases and 2 cases respectively. None of them presented with Stage-IV carcinoma . Poor disease free survival rate corresponds to Triple negative cancers (24%). CONCLUSION - This study comprises higher Incidence rate (i.e 2.5%) of male breast cancers compared to national data, as it was done in a tertiary health care centre. Effort to increase awareness among patients, earlier presentation to clinicians, timely diagnosis before spreading to axilla and other organs, and evidence based treatment would be helpful in optimizing the management of this rare disease. [ABSTRACT FROM AUTHOR]

Lacrimal gland adenoid cystic carcinoma (LGACC) is the most common primary malignant epithelial tumor of the lacrimal gland and has the characteristics of high recurrence rate, neurotropic growth, and risk of distant metastasis. The clinical manifestation is mainly a mass in the lacrimal gland area with a poor specificity. The combination of MRI and CT is important in the diagnosis of LGACC, and PET/CT is of great value in determining the nature and metastasis of LGACC. Histopathological examination is the gold standard for diagnosis, and the type of histopathology is significant for predicting the prognosis of patients. At present, the most commonly used treatment for LGACC is surgical resection combined with postoperative local radiotherapy. However, the overall prognosis is poor after active treatment because the pathogenesis of LGACC remains unclear. This article will combine relevant literature and the author’s clinical experience to review the epidemiology, clinical manifestations, imaging examination, histopathological changes, treatment, and prognosis of LGACC. Results will contribute to improve the quality of diagnosis and treatment and the prognosis of patients. [ABSTRACT FROM AUTHOR]

Carbon ion radiotherapy (CIRT) can deliver high-dose radiation to a tumor with minimum damage to normal tissue. Recently, transoral surgery (TOS) has become a treatment option for locoregional recurrence after radiotherapy for laryngopharyngeal carcinoma, aimed at preserving laryngeal function. A 67-year-old woman with crT2N0M0 adenoid cystic carcinoma of the tongue base, previously cured with CIRT, underwent salvage endoscopic laryngopharyngeal surgery at another hospital. One month after the surgery, she suffered massive pharyngeal bleeding and was transferred to our hospital for emergency hemostasis. We observed massive necrosis of the tongue base, extending to the epiglottic vallecula, and bleeding from the wound. Consequently, surgical debridement and cauterization were performed. Although wound healing took several months, laryngeal function was finally preserved. Careful postoperative observation is required when salvage TOS is performed in patients who previously underwent CIRT. The efficacy and safety of the procedure needs to be carefully evaluated in the future. [ABSTRACT FROM AUTHOR]

Background: This study analyzed the predictive value of artificial intelligence (AI)‐powered tumor‐infiltrating lymphocyte (TIL) analysis in recurrent or metastatic (R/M) adenoid cystic carcinoma (ACC) treated with axitinib. Methods: Patients from a multicenter, prospective phase II trial evaluating axitinib efficacy in R/M ACC were included in this study. H&E whole‐side images of archival tumor tissues were analyzed by Lunit SCOPE IO, an AI‐powered spatial TIL analyzer. Results: Twenty‐seven patients were included in the analysis. The best response was stable disease, and the median progression‐free survival (PFS) was 11.1 months (95% CI, 9.2–13.7 months). Median TIL densities in the cancer and surrounding stroma were 25.8/mm2 (IQR, 8.3–73.0) and 180.4/mm2 (IQR, 69.6–342.8), respectively. Patients with stromal TIL density >342.5/mm2 exhibited longer PFS (p = 0.012). Conclusions: Cancer and stromal area TIL infiltration were generally low in R/M ACC. Higher stromal TIL infiltration was associated with a longer PFS with axitinib treatment. [ABSTRACT FROM AUTHOR]

Purpose: To describe the clinical and morphologic changes in the ocular surface microstructure of patients affected with moderate-to-severe Atopic Dermatitis (AD) before and during Dupilumab treatment. Methods: This is a monocentric observational study on thirty-three patients affected with AD before and during Dupilumab treatment. All patients underwent a slit-lamp examination: complete clinical assessment, Break Up Time test (BUT), Schirmer test, and corneal staining grading (Oxford scale) were performed. Meibomian Glands Dysfunction (MGD) evaluation (Meibography), Non-invasive Keratograph Break Up Time test (NIKBUT), Tear Meniscus Height (TMH), and ocular Redness Score (RS) have been investigated using an OCULUS Keratograph. In vivo images of the conjunctiva, cornea, and meibomian glands have been acquired by confocal microscopy. Results: Sixty-six eyes were included in our study: twenty-two eyes of 11 naive patients with indication for treatment but not in therapy yet (Group 1) and forty-four eyes of 22 patients treated with Dupilumab for at least 4 months (subcutaneous administration of 300 mg every 2 weeks) (Group 2). Either patients treated with Dupilumab or naive patients with moderate-to-severe forms of AD had a tear film instability (TBUT and NIKBUT reduced), whereas the quantity of the tear film was overall normal (Schirmer test and TMH), without statistically significant differences between the two groups. When Meibography was performed with the Keratograph, the difference between Group 1 and Group 2 was statistically significant in terms of Meiboscore (p = 0.0043 and p = 0.0242, respectively), as well as the difference in terms of mean RS. These results paired well with the confocal microscopy results in which we found a decrease in the goblet cell population in the conjunctival epithelium in the treated group (5.2 cells/mm), along with inflammatory cells that were more concentrated around the adenoid lumina of the meibomian glands. Conclusions: In recent years, the use of Dupilumab has been increasing, but mild-to-severe conjunctivitis is a common side effect. Our major results demonstrate a loss of meibomian glands at the Keratograph examination: we can assume a reduced meibum secretion and an evaporative dry eye with MGD. We suggest that the inflammation of the ocular surface may involve not only the cornea and the conjunctiva, but also the meibomian glands, and Dupilumab may play a role. However, the frequency of clear conjunctivitis is not as common as reported in the literature. [ABSTRACT FROM AUTHOR]

Background and Objectives: Adenoid cystic carcinoma (ACC) of the head and neck is generally slow-growing but has a high potential for local recurrence and metastasis to distant organs. There is currently no standard pharmacological treatment for recurrent/metastatic (R/M) ACC, and there are cases in which immune checkpoint inhibitors (ICIs) are administered for ACC according to head and neck squamous cell carcinoma (HNSCC). However, the efficacy of ICIs for ACC remains unclear, and the predictive biomarkers need to be elucidated. Materials and Methods: The Center for Cancer Genomics and Advanced Therapeutics (C-CAT) database enabled the retrospective but nationwide analysis of 263 cases of ACC of the head and neck. Then, we examined and reported four cases of ACC that received ICIs and comprehensive genomic profiling (CGP) in our institution. Results: The C-CAT database revealed that 59 cases out of 263 received ICIs, and the best response was 8% of objective response rate (ORR) and 53% of disease control rate (DCR) (complete response, CR 3%, partial response, PR 5%, stable disease, SD 44%, progressive disease, PD 19%, not evaluated, NE 29%). The tumor mutational burden (TMB) in ACC was lower overall compared to HNSCC and could not be useful in predicting the efficacy of ICIs. Some cases with MYB structural variants showed the response to ICIs in the C-CAT database. A patient with MYB fusion/rearrangement variants in our institution showed long-term stable disease. Conclusions: ICI therapy is a potential treatment option, and the MYB structural variant might be a candidate for predictive biomarkers for immunotherapy in patients with R/M ACC. [ABSTRACT FROM AUTHOR]

Background: Adenoid cystic carcinoma (AdCC), associated with MYB/MYBL1 gene rearrangements, shows epithelial and basaloid myoepithelial cells arranged in tubular, cribriform and solid patterns. Variations from this classic morphology make diagnosis challenging, necessitating molecular testing. AdCC with striking tubular hypereosinophilia (AdCC-STE) is one such recently described histological subtype. Methods: A 52-year-old female presented with a floor of mouth swelling for two months, diagnosed elsewhere as polymorphous adenocarcinoma (PAC). A biopsy was obtained. With a diagnosis of oncocytic neoplasm, wide excision of the tumor was undertaken. Histological examination, fluorescence in situ hybridization (FISH) and ultrastructural examination were performed. Archival cases of PAC and epithelial myoepithelial carcinoma (EMC) were reviewed, and MYB immunostaining and FISH were performed to identify potential AdCC-STE cases. Results: The excised tumor from the index patient showed bilayered tubules, micropapillae and cribriform pattern. Luminal cells with hypereosinophilic to clear cytoplasm were surrounded by flattened abluminal cells. Focally, basophilic matrix was seen within sharply demarcated pseudocystic spaces. FISH revealed MYB and EWSR1 gene rearrangements, confirmatory of AdCC-STE. Electron microscopy showed features consistent with AdCC; however, mitochondria were not prominent. Among 14 archival PACs, two showed MYB immunopositivity; one showed MYB rearrangement but was classical AdCC. Among 35 EMC, one case showed MYB immunoreactivity and eosinophilia of luminal cells but lacked MYB/MYBL1 rearrangement. Conclusion: Awareness of unusual histological subtypes of AdCC, such as AdCC-STE, is imperative, as it may be misdiagnosed as PAC and EMC, among others. Presence of basophilic matrix and squamoid morules in a biphasic tumor even with hypereosinophilic rather than basaloid myoepithelial appearance should raise suspicion for AdCC-STE, and prompt molecular testing for confirmation. With wider accessibility, lower cost and significantly shorter turn-around-time when compared to RNA sequencing, FISH can be employed for confirmation of diagnosis, especially in low- and middle-income countries. [ABSTRACT FROM AUTHOR]

Introduction/Justification: Adenoid cystic carcinoma (ACC) is a tumor of the salivary glands, characterized by insidious growth, recurrences, and distant metastases. Objectives: This study aimed to describe the findings of PET/CT images performed with 18 F-FDG (FDG PET/CT) and 18 F-PSMA-1007 (PSMA PET/CT) in patients with relapsed ACC to verify whether any of these studies are more suitable for identifying local recurrence and distant metastases. Materials and Methods: Patients were submitted to restaging PET/CT studies with 18 F-FDG and 18 F- PSMA-1007 with a 24-hour interval between exams before treatment. Two nuclear medicine physicians compared imaging findings. Results: Patient 1. P.A.C., a 29-year-old female, was diagnosed with ACC of the parotid in 2016. She underwent total parotidectomy and RT. In 2021, a chest computed tomography (CT) identified lung nodules, and the patient underwent resection of the largest lesions. In 2024, the patient was submitted to restaging images with FDG PET/CT that were negative for metastases, but PSMA PET/CT images identified mild PSMA uptake in two pulmonary nodules (0.8 cm, SUV = 2.2; 0.9 cm, SUV = 3.4) suspicious for ACC metastases. The patient remains asymptomatic under supervised follow-up. Patient 2. L.C.O., a 49-year-old male with newly diagnosed ACC in the salivary gland, underwent tumor resection and RT in 2010. The patient recurred in lungs and skull and was submitted to resection of the lung nodules and total skull radiotherapy (RT). In 2022, the patient underwent RT to a metastasis in the 5th lumbar vertebrae. In 2023, FDG PET/CT revealed hypermetabolism in multiple pulmonary nodules (the largest measuring 1.8 cm, SUV = 13.4) and in the L5 vertebrae (SUV = 8.5), consistent with metastases. The PSMA PET/CT showed only mild PSMA uptake in the pulmonary nodules (the largest nodule had a SUV = 4.7) and similar PSMA uptake (as FDG) in L5 vertebrae (SUV = 8.7). The patient is currently asymptomatic. Patient 3. P.C.S., a 46- year-old male, was diagnosed with ACC in the parapharyngeal space and underwent surgical resection followed by RT in 2008. In 2022, a chest CT identified lung metastases, the largest nodule with 3.8 cm. In 2023, a FDG PET/CT demonstrated hypermetabolic lung nodule metastases (the largest measuring 3.0 and 3.8 cm; SUV = 12.3 and SUV = 6.1, respectively). The FDG PET/CT also demonstrated multiple liver nodules (the largest measuring 2.7 cm) without FDG uptake, suspicious for metastases. A PSMA PET/CT showed PSMA uptake in the same lung nodules, however incongruent when compared to FDG uptake: the two nodules measuring 3.0 and 3.8 cm had SUVs of 5.2 and 8.8, respectively). The patient currently reports dyspnea during moderate-intensity physical activity. Conclusion: The data show heterogeneity in FDG PET/CT and PSMA PET/CT findings in relapsed ACC. Combining both PET/CT radiotracers can provide additional information for monitoring patients. PSMA PET/CT has the advantage of the possibility of a theranostic approach. Acknowledgements: The study was supported by Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES), Fundação de Apoio ao Ensino e à Pesquisa do Estado de São Paulo (Cancer Theranostics Innovation Center, CEPID FAPESP #2021/10265-8), and International Atomic Energy Agency (IAEA) technical cooperation projects for development of Latin American Countries (IAEA/TCLAC: EX-BRA6033-2401375).

Abstract Objective The purpose of this retrospective study was to describe the clinicopathological characteristics of primary adenoid cystic carcinoma (ACC) of the palate and to identify the factors affecting prognosis. Methods The medical records of 85 patients with primary ACC of the palate treated with surgery, with or without adjuvant radiotherapy/chemotherapy, from 2009 to 2019 were reviewed. The relationship of different clinical parameters with locoregional recurrence (LR), distant metastasis (DM), and overall survival (OS) were analyzed. Results Median follow‐up time was 44.6 months. LR and DM rates were 24.7% and 25.9%, respectively, and the 5‐year OS and disease‐free survival (DFS) rates were 85.9% and 55.1%, respectively. Multivariate analysis showed that positive margins were independently associated with the risk of LR (p

Abstract Background Thoracic adenoid cystic carcinoma (ACC) is rare, and the differences between tracheal and lung lesions have not been fully understood. Methods Patients were identified from a Chinese cancer center (FUSCC) (2005–2022) and the Surveillance, Epidemiology, and End Results (SEER) database (2000–2019). Incidence was calculated and trends were quantified. Clinicopathological features and overall survival (OS) were analyzed. Nomograms predicting OS were constructed. Results Totally, 55 tracheal adenoid cystic carcinoma (TACC) and 25 lung and bronchus adenoid cystic carcinoma (LACC) were included in a Chinese cohort, 121 TACC and 162 LACC included in the SEER cohort. There were larger tumor sizes, more lymph nodes and distant metastases for LACC than TACC patients. TACC patients are more likely to get local treatments. Patients with LACC had significantly worse median OS than patients with TACC (SEER cohort: 68.0 months vs. 109.0 months, p = 0.001, Chinese cohort: 62.9 months vs. 124.8 months, p = 0.061). Age, lymph node metastasis, distant metastasis and local treatment were identified as independent prognostic factors for OS of TACC. Distant metastasis and local treatment were identified for LACC. Specifically, surgery alone or in combination with radiotherapy is crucial for improving survival in both TACC and LACC. Only TACC benefits from radiotherapy alone, while chemotherapy does not improve survival for either. The nomograms constructed using these factors revealed good prognostic accuracy. Conclusions LACC is more aggressive and has a worse prognosis than TACC. TACC patients have more opportunities for local treatment, which is important for the prognosis of both TACC and LACC. Nomograms were created for TACC and LACC to aid in personalized survival predictions and clinical decisions.

Abstract Background Primary adenoid cystic carcinoma (AdCC) of the tracheobronchial tree is very rare with a high risk for recurrence and metastasis. The diagnosis of AdCC by histologic and immunohistochemical means has been well studied clinically. However, the identification of AdCC by cytologic features remains elusive due to the atypical features the cancer presents. This study aimed to describe the cytologic features of AdCC by using bronchial brushing, which could aid in distinguishing AdCC from other pulmonary carcinomas. Methods The cytopathological features of bronchial brushing smears collected from seven cases were histologically diagnosed as AdCC. The defined cytologic features, which could potentially be diagnostic, were systemically analyzed. Results Four out of the seven cytologic cases were inconcordance with the histologic diagnosis and cytologically classified as positive for malignant cells, small cell carcinoma, or atypical cells. Three cases showed a characteristic adenoid structure and magenta stroma forming globule, which was distinguished from the four cases. Cytologically, the above mentioned three cases were uniform with relatively small bland nuclei and little cytoplasm. In this study, only one case showed atypical polygonal medium-sized cells with conspicuous nucleoli. Conclusions Unlike fine-needle aspiration cytology, magenta stroma globules might offer an alternate clue for cytodiagnosis of AdCC clinically. Bronchial brushings cytology was more present in bland uniform cells with high nuclear to cytoplasmic ratios and background mucoid substance. More cases should be collected and confirmed using histopathology with careful film reading to reduce the rate of misdiagnosis.

High rates of recurrence and distant metastasis are a foremost challenge in the management of adenoid cystic carcinoma (ACC), occurring in approximately 40% of all ACC patients. Despite the morbidity and mortality resulting from recurrent/metastatic (R/M) disease, there are no FDA-approved systemic agents for these patients. In this review, we summarize pertinent ACC pathophysiology and its implications for different systemic treatment regimens in R/M ACC. We review the evidence for the most widely used systemic agents - cytotoxic chemotherapy and tyrosine kinase inhibitors (TKIs) targeting VEGFR - in addition to immune checkpoint inhibitors and non-TKI biologic agents. Exciting emerging targets for R/M ACC, including inhibitors of Notch signaling, stemness, PRMT5, and Axl, are also discussed. Lastly, we review local therapies for small-volume lung disease in patients with oligometastatic ACC, specifically pulmonary metastasectomy and stereotactic body radiation therapy (SBRT). Future development of targeted molecular agents which exploit the underlying biology of this disease may yield novel therapeutic options to improve clinical outcomes in patients with R/M ACC.

Breast cancers of either ductal or lobular pathology make up the vast majority of breast malignancies. Other cancers occur rarely in the breast. Benign pathology can at times mimic breast cancers on imaging and initial needle biopsies. We report a rare breast pathology of cylindroma. Cylindromas are usually benign, rare dermatologic lesions most commonly associated with head or neck locations. They more commonly occur as sporadic and solitary masses. Less commonly is an autosomal-dominant multi-centric form of this disease. Malignant cylindromas are very rare. We present a patient with findings of a cylindroma of the breast after excision. This was initially felt to be concerning for breast cancer on imaging and core biopsy. Treatment of cylindromas of the breast is excision. Sentinel lymph node dissection is not indicated, nor are adjuvant therapies when identified in the breast. This lesion needs to be included in the differential diagnosis for breast cancer. If cylindromas can be accurately diagnosed preoperatively, this would negate the need for consideration of axillary nodal surgery and adjuvant therapies. [ABSTRACT FROM AUTHOR]

This article discusses a case study of a patient with a low-grade carcinoma with acinic cell carcinoma-like features in the parotid gland. The study identified a novel fusion gene, CRTC3::IQGAP1, in the tumor. The fusion gene is believed to contribute to the development of the tumor, although its exact role is still unknown. Further research is needed to determine the significance of the CRTC3::IQGAP1 fusion gene in salivary gland tumors. [Extracted from the article]

A 62-year-old man presented to a clinic with multiple dome-shaped papules on his scalp that had been present for over 10 years without any changes. Shave biopsies were performed, and the diagnosis was determined to be spiradenocylindroma, an uncommon dermal tumor with features that overlap with spiradenoma and cylindroma. The patient declined further genetic workup but continues to follow up with dermatology for monitoring of the lesions. It is important for physicians to consider genetic testing and review the family history when patients present with multiple cylindromas, spiradenomas, or spiradenocylindromas. [Extracted from the article]

This article is an editorial that discusses the diagnosis, epidemiology, and treatment of salivary gland carcinomas (SGCs), a rare type of cancer. It emphasizes the need for collaborative research networks to improve care for patients with SGCs and highlights recent advances in molecular profiling. The article also emphasizes the importance of histology, immunohistochemistry, and molecular characterization in diagnosis and treatment decisions. Additionally, the document provides references for two guidelines on the management of salivary gland malignancy. [Extracted from the article]

Adenoid cystic carcinoma is a rare, slow‑growing tumor that develops from the mucous glands’ epithelium. Most commonly, it develops in salivary glands and is rare in the nose and paranasal sinuses. It is common in the fourth to sixth decade of life, with a female preponderance. We present a case of a 40‑year‑old male who came with complaints of right‑sided nasal obstruction, which was clinically and radiologically diagnosed as a mucocele. He underwent endoscopic excision of the mass. Histopathology was suggestive of adenoid cystic carcinoma. Later, the patient underwent right orbital floor‑sparing total maxillectomy, followed by adjuvant radiotherapy. [ABSTRACT FROM AUTHOR]

This article discusses the rare co-occurrence of granulomatous mastitis and collagenous spherulosis in a breast lump. The case study involves a 65-year-old female with a gradually progressive lump in her right breast. Fine needle aspiration cytology (FNAC) was performed, and the smears showed ill-formed granulomas, inflammatory cells, and homogeneous hyaline stromal globular elements. The diagnosis was a benign breast lesion: collagenous spherulosis with granulomatous mastitis. The article emphasizes the importance of recognizing the cytomorphological features to aid in the cytological diagnosis. [Extracted from the article]