Examining progression of advanced lacrimal gland adenoid cystic carcinoma
After endoscopic ultrasound (EUS), the patient underwent endoscopic submucosal excision (ESE).
Adenoid cystic carcinoma (ACC) is a malignant tumor characterized by the biphasic ductal and myoepithelial differentiation, a propensity for perineural invasion and distant metastasis, and relatively slow local progression. ACC primarily arises in the salivary glands, esophageal adenoid cystic carcinoma (EACC) often presents as a submucosal elevation with a smooth surface on endoscopy. This atypical morphological presentation often results in conventional mucosal biopsy sampling of only the normal squamous epithelium, leading to frequent preoperative misdiagnoses of EACC despite endoscopic detection. We report a 70‑year‑old male with an esophageal submucosal elevation detected via gastroscopy. After endoscopic ultrasound (EUS), the patient underwent endoscopic submucosal excision (ESE). Postoperative histopathology confirmed ACC with positive margins, after which patient received adjuvant radiotherapy and has remained clinically well on follow‑up. This study aimed to explore the endoscopic features and diagnostic challenges of EACC and to discuss a comprehensive treatment approach integrating endoscopic resection with radiotherapy.
EACC is a rare esophageal malignant tumor that is frequently misdiagnosed due to its submucosal growth. This case demonstrates that endoscopic submucosal excision (ESE) can provide an adequate therapeutic and diagnostic approach, particularly when combined with adjuvant radiotherapy for positive surgical margins.
Evidence level: Klinikai vizsgálat. Formális klinikai vizsgálati eredmény.
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