Malignant Pleural Effusion, an Unusual Presentation of Metastatic Adenoid Cystic Carcinoma: A Case Report and Review of the Literature

Ayesha Arshad, MD


Adenoid cystic carcinoma (ACC) is an uncommon malignant neoplasm of the major and minor salivary glands that is known to have a long clinical course, behaving in an insidious and indolent fashion with multiple recurrences preceding distant metastasis. Reported here is a case of a patient presenting with shortness of breath and recurrent pleural effusion. Exfoliated ACC cells were observed on cytological evaluation, a rare occurrence. Mediastinal lymph node involvement was also confirmed on cytology. A primary site of origin was not found. In summary ACC can present in various body sites and pathologists should consider ACC in the differential diagnosis of a basaloid carcinoma of uncertain origin.

[N A J Med Sci. 2017;10(1):8-12.   DOI:  10.7156/najms.2017.1001008]



adenoid cystic carcinoma, pleural effusion, metastatic tumor

Full Text:



Mitra S, Kundu S, Pattari SK, et al. Metastatic Pleural effusion: A rare presentation of salivary gland adenoid cystic carcinoma. Indian Journal of Chest Dis. Allied Sci. 2011;53:107-110.

Florentine BD, Fink T, Avidan S, et al. Extra Salivary gland presentations of Adenoid Cystic carcinoma: A report of Three cases. Diagn Cytopathol. 2006 ;34:491-494.

Bradley PJ. Adenoid cystic carcinoma of the head and neck: A review. Curr Opin Otolaryngol Head and Neck Surg. 2004;12:127-132.

Adenoid Cystic Carcinoma of the Lung.

Wenig, BM ed. Atlas of Head and Neck Pathology; 2nd Ed. New York, NY: Elsevier, Publisher; 2016.

Kitada M, Ozawa K, Sato K, et al. Adenoid Cystic carcinoma of the peripheral lung: A case report. World J Surg Oncol. 2010;8:74.

Moran CA, Suster S, Koss MN. Primary Adenoid Cystic carcinoma of the lung. A clinicopathologic and Immunohistochemical study of 16 cases. Cancer. 1994;73:1390-1397.

Giannini PJ, Shetty KV, Horan SL, et al. Adenoid cystic carcinoma of the buccal vestibule: Case report and review of the literature. Oral Oncology. 2006;42:1029-1032.

Hu M, Hu Y, He J, et al. Primary adenoid cystic carcinoma of the lung: Clinicopathologic features, treatment and results. Oncol Lett. 2015;9:1475-1481.

Triantafillidou K, Dimitrakopoulos J, Iordanidis F, et al. Management of Adenoid Cystic carcinoma of minor salivary glands. J Oral Maxillofac Surg. 2006;64:1114-1120.

Ko YH, Lee MA, Hong YS, et al. Prognostic factors affecting the clinical outcome of Adenoid Cystic Carcinoma of the Head and Neck. Jpn J Clin Oncol. 2007;37:805-811.

Torre W, Comellas M, Cuesta M. Massive pleural effusion an isolated manifestation of metastatic spread of salivary adenoid cystic carcinoma. Respir Med. 1997;91:169-170.

Sur RK, Donde B, Levin V, et al. Adenoid Cystic carcinoma of the salivary glands: A review of 10 years. Laryngoscope. 1997;107:1276-1280.

Zhu F, Liu Z, Hou Y, et al. Primary Salivary Gland-Type Lung cancer-Clinicopathologic analysis of 88 cases from China. J Thorac Oncol. 2013;8:1578-1584.

Lin C-M, Li A F.-Y, Wu L.-H, et al. Adenoid Cystic Carcinoma of the trachea and bronchus-a clinicopathologic study with DNA flow cytometric analysis and oncogene expression. Eur J Cardiothorac Surg. 2002;22:621-625.

Spiro RH. Distant Metastasis in Adenoid Cystic carcinoma of salivary gland origin. Am J Surg. 1997;174:495-498.

Locati LD, Guzzo M, Bossi P, et al. Lung metastasectomy in adenoid cystic carcinoma (ACC) of salivary gland. Oral Oncology. 2005;41:890-894.

Perzin KH, Gullan P, Clairmont AC. Adenoid Cystic carcinoma arising in salivary glands: a correlation of histologic features and clinical course. Cancer. 1978;42:265-282.

Maziak DE, Todd TRJ, Keshavji SH, et al. Adenoid Cystic carcinoma of the airway: Thirty-two-year experience. J Thorac Cardiovasc Surg. 1996;112:1522-1532.

Spiro RH, Huvos AG, Strong EW. Adenoid cystic carcinoma: factors influencing survival. Am J of Surg. 1979;138:570-583.

Min R, Siyi L, Wenjun Y, et al. Salivary gland adenoid cystic carcinoma with cervical lymph node metastasis: a preliminary study of 62 cases. Int J Oral Maxillofac Surg. 2012;41:952-957.

Stell PM, Cruickshank AH, Stoney PJ, et al. Lymph node metastasis in Adenoid Cystic carcinoma. Am J Otolayngol. 1985;6:433-436.

Allen A, Rabin M, Reilly J, et al. Unresectable adenoid cystic carcinoma of the Trachea treated with chemoradiation. J Clin Oncol. 2007;25:5521-5523.


  • There are currently no refbacks.