Adenosquamous cell carcinoma of tonsil is a rare lesion of head and neck and is often misdiagnosed as squamous cell carcinoma. It has a very aggressive clinical pattern. We encountered a patient with an adenosquamous cell carcinoma of tonsil and performed various treatment modalities including surgical resection, radiation therapy, chemotherapy but the patient expired two years after the first diagnosis. Such case has never been reported earlier in Korea. Herein, we present this rare case with a review of related literature.
Carcinoma, Adenosquamous ; Carcinoma, Squamous Cell ; Diagnosis ; Drug Therapy ; Head ; Humans ; Korea ; Neck ; Palatine Tonsil

BACKGROUND: The incidence and the mortality of lung cancer rank first among all malignant tumors and it seriously affects human health. The common types of non-small cell lung cancer (NSCLC) are adenocarcinoma and squamous carcinoma with clinical research and more attention, while adenosquamous carcinoma is a rare pathological subtype of lung cancer, which clinical features and prognostic factors are not yet fully understood. The purpose of this study is to analyze the clinical features and prognosis of lung adenosquamous carcinoma, and construct a nomogram to predict the patients' prognosis. METHODS: We obtained the data of adenosquamous carcinoma patients diagnosed between 2010 and 2015 in the Surveillance, Epidemiology, and End Results (SEER) database of the United States, and compared their clinical features and prognosis with those of lung adenocarcinoma and lung squamous cell carcinoma patients in the same period. Then we used univariate and multivariate analyses to explore the independent prognostic factors of adenosquamous carcinoma. Finally, we constructed and validated a nomogram to visually predict the outcomes of lung adenosquamous carcinoma. RESULTS: 1,453 patients with lung adenosquamous carcinoma were finally included. Compared with patients with lung adenocarcinoma and lung squamous cell carcinoma, the distributions of lung adenocarcinoma patients in most of the variables were medium between lung adenocarcinoma and squamous cell carcinoma. The prognosis of adenosquamous carcinoma was better than that of lung squamous cell carcinoma, but worse than that of lung adenocarcinoma. Multivariate analysis showed that age, differentiation, tumor-node-metastasis (TNM), surgery, and chemotherapy were independent prognostic factors (all P were less than 0.001). We constructed a nomogram with a C-index of 0.783 (0.767-0.799). The distinction test and consistency test showed that the nomogram could predict the patient's prognosis effectively. CONCLUSIONS Lung adenosquamous carcinoma has unique clinical, pathological, and prognostic characteristics. Age, differentiation, T, N, M, surgery, and chemotherapy status are independent predictors of prognosis in patients with adenosquamous carcinoma. Our nomogram can efficiently predict the prognosis of patients.
Aged ; Aged, 80 and over ; Carcinoma, Adenosquamous ; diagnosis ; epidemiology ; pathology ; therapy ; Databases, Factual ; Female ; Humans ; Lung Neoplasms ; diagnosis ; epidemiology ; pathology ; Male ; Middle Aged ; Neoplasm Staging ; Prognosis ; Survival Analysis

We report the case of a 33-year-old lactating woman who presented with a 10-cm breast abscess. Biopsy of the abscess wall revealed a poorly differentiated invasive ductal carcinoma. The patient had no family history of breast cancer or other risk factors for breast cancer. The disease was considered to be a large noninflammatory invasive breast cancer, for which the patient received neoadjuvant chemotherapy, breast-conserving surgery using axillary dissection (the patient did not consent to a mastectomy), and postoperative radiotherapy. Final histologic examination revealed a 4-cm, triple negative, high-grade adenosquamous carcinoma. At follow-up four years after surgery, the patient was doing well with no signs of recurrence. Adenosquamous carcinoma is an extremely rare disease that mainly presents in low-grade forms. High-grade forms are aggressive and frequently present with axillary involvement. To the best of our knowledge, there has been no report of adenosquamous carcinoma presenting as a breast abscess in the literature. The case we report highlights that, although rare, cancer should be considered in lactating breast abscesses.
Adult ; Breast Neoplasms ; diagnosis ; drug therapy ; radiotherapy ; surgery ; Carcinoma, Adenosquamous ; diagnosis ; drug therapy ; radiotherapy ; surgery ; Carcinoma, Ductal, Breast ; diagnosis ; drug therapy ; radiotherapy ; surgery ; Female ; Humans ; Inflammation ; Lactation ; Risk Factors ; Treatment Outcome

Primary adenosquamous carcinoma of the gallbladder is an extremely uncommon neoplasm which accounts for approximately 2% of carcinomas of the gallbladder. According to a recent extensive review of carcinomas of the gallbladder, the dismal outlook for this carcinoma still prevails in spite of recent advances in diagnostic and surgical techniques because of late diagnosis and ineffectual treatment. A sixty-one-year-old female patient visited the Department of Internal Medicine due to postprandial epigastric discomfort. Abdominal sonography, abdominal computed tomography (CT), and endoscopic retrograde cholangiopancreatography (ERCP) were performed. We treated the patient with a cholecystectomy and chemotherapy with FAM. However, five months after discharge, the patient revisited, complaining of epigastric discomfort. We performed abdominal CT and gastrofiberscopy. The result was a recurrence of the cancer in the bed of the gallbladder and in the liver. However, the patient and her family did not want more treatment for the metastase of the cancer. We experienced one case of an adenosquamous-cell carcinoma of the gallbladder, and we report this rare cancer with a review of the literature.
Carcinoma, Adenosquamous ; Cholangiopancreatography, Endoscopic Retrograde ; Cholecystectomy ; Delayed Diagnosis ; Drug Therapy ; Female ; Gallbladder* ; Humans ; Internal Medicine ; Liver ; Recurrence ; Tomography, X-Ray Computed

Most malignant tumors originating from the biliary tract are adenocarcinomas, and adenosqamous carcinoma of Klatskin's tumor is a very rare finding. An 83-yr-old man was admitted to our hospital because of jaundice. The abdominal computed tomography and magnetic resonance cholangiopancreatography revealed wall thickening and luminal stenosis of both the intrahepatic duct confluent portion and the common hepatic duct. These findings were compatible with Klatskin's tumor, Bismuth type III. Considering the patient's old age, palliative combined modality therapy was performed. After percutaneous transhepatic biliary drainage, biopsy was performed via percutaneous transhepatic cholangioscopy. The histopathologic findings showed adenosquamous carcinoma. External radiotherapy and intraluminal brachytherapy through the endobiliary Y-type stent were then done. Nine months after the radiotherapy, the laboratory findings and the abdominal computed tomography revealed biliary obstruction and progressive hepatic metastasis. The combined modality therapy of external radiotherapy, intraluminal brachytherapy and stenting assisted him to live a normal life until he finally experienced biliary obstruction.
Aged, 80 and over ; Bile Duct Neoplasms/*diagnosis/therapy ; *Bile Ducts, Extrahepatic ; Carcinoma, Adenosquamous/*diagnosis/therapy ; Cholangiography ; Combined Modality Therapy ; Humans ; Jaundice/etiology ; Male ; *Palliative Care ; Stents ; Tomography, X-Ray Computed

OBJECTIVEThis study was to review the clinical features, diagnosis, treatment, and prognosis of esophageal adenosquamous carcinoma (ASC).

METHODSClinical data of 22 patients with pathologically confirmed esophageal ASC, treated in the Cancer Center of Sun Yat-sen University from May 1988 to April 2006, were retrospectively analyzed. The survival analysis was performed using Kaplan-Meier method.

RESULTSOf 4208 patients diagnosed as esophageal cancer during the same time in our center, only 22 had esophageal ASC, accounted for 0.52%. The median age of the 22 cases was 60 years (range, 42 to 69 years). Esophageal ASC showed similar clinical symptoms, radiological and endoscopic features to esophageal squamous cell carcinoma (ESCC). Nineteen cases were preoperatively misdiagnosed as ESCC by endoscopic biopsy. Among the 22 patients, 16 were treated by surgery alone, 3 by surgery plus postoperative radiotherapy, and the remaining 3 by radiotherapy, sequential chemoradiotherapy and concurrent chemoradiotherapy, each in one case, respectively. The overall 1-, 3- and 5-year survival rates were 67.6%, 33.8% and 18.1%, respectively, with a median survival time of 24.5 months.

CONCLUSIONEsophageal adenosquamous carcinoma is a rare esophageal disease and prone to be misdiagnosed as esophageal squamous cell carcinoma. Initial surgical treatment combined with other therapies is suggested. The prognosis of esophageal adenosquamous carcinoma has not yet been well established.

Adult ; Aged ; Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Bone Neoplasms ; secondary ; Carcinoma, Adenosquamous ; diagnosis ; therapy ; Carcinoma, Squamous Cell ; diagnosis ; Cisplatin ; administration & dosage ; Diagnostic Errors ; Esophageal Neoplasms ; diagnosis ; pathology ; therapy ; Esophagectomy ; methods ; Female ; Fluorouracil ; administration & dosage ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Neoplasm Recurrence, Local ; Neoplasm Staging ; Retrospective Studies ; Survival Rate