Renal Metastases from a Nasal Cavity Mixed Squamous Cell and Adenoid Cystic Carcinoma: A Case Report
Challenging differential diagnosis, Unusual setting of medical care, Rare disease
Raffaele Longo, Camille Jaud, William Gehin, Laurent Hennequin, Claire Bastien, Marco Campitiello, Antonio Rozzi, Francesca Plastino
Division of Medical Oncology, “Centre Hospital Regional (CHR) Metz-Thionville”, Ars-Laquenexy, France
Am J Case Rep 2020; 21:e919781
Adenoid cystic carcinoma (ACC) is a very rare tumor with a high risk of loco-regional recurrence and potential distant metastases. Until now, only a few cases of renal metastases from ACC have been reported in the literature.
CASE REPORT: A 64-year-old, Caucasian, non-smoker female, 8 months after being treated by radio-chemotherapy for a squamous cell nasal cavity tumor, presented two renal lesions associated with lung and vertebral metastases. Histology was consisted with a metastasis from an ACC. The histological revision of the primary nasal tumor confirmed a squamous cells carcinoma with an adenoid cystic component that metastasized to the kidney. Renal lesions appeared hypometabolic at the ¹⁸F-fluorodeoxyglucose (¹⁸F-FDG) PET scan mimicking a primary renal tumor. The patient underwent a systemic, palliative chemotherapy by a weekly carboplatin/paclitaxel/cetuximab regimen that was well tolerated and allowed a lasting tumor control.
CONCLUSIONS: The particularity of this case relies on the rarity of renal metastasis from ACC, its difficult diagnosis, and the complexity of its management, as no standard chemotherapy has been validated for metastatic ACC, yet. In our case, a weekly carboplatin/paclitaxel/cetuximab regimen was administered leading to a durable tumor stabilization with an excellent patient’s quality of life.
Keywords: Carcinoma, Adenoid Cystic, Neoplasm Metastasis, Neoplasms, Squamous Cell