1.Adenoid cystic carcinoma of the breast: A case report.
Aveline Marie D. Ylanan ; Miriam Joy C. Calaguas
Acta Medica Philippina 2026;60(7):107-111
Adenoid cystic carcinoma (ACC) is a rare subtype of invasive breast cancer, occurring in <0.1% of all malignant breast tumors. Though majority are triple-negative, ACC of the breast has good prognosis with a low incidence of regional and distant metastases.
A 45-year-old premenopausal female presented with a 5-month history of a gradually enlarging mass on her left breast. After core needle biopsy and subsequent metastatic work-up, she underwent total mastectomy with sentinel lymph node biopsy. Final histopathology showed adenoid cystic carcinoma, 2.1 cm in size and no lymph nodes positive for tumor. She has completed adjuvant radiotherapy of 50 Gy to the chestwall, and is currently well after 6 years of follow-up.
Surgery with either lumpectomy or mastectomy has been established as the mainstay of treatment of adenoid cystic carcinoma of the breast, but the use of adjuvant radiotherapy (RT) and chemotherapy has not been established. While adjuvant RT has been shown to improve cause-specific and overall survival following breast-conserving surgery, its indications after a mastectomy are not as well-defined. The decision to administer adjuvant RT was based on the current evidence indicating the advantages of adjuvant treatment for breast carcinomas, lack of survival difference between invasive ductal carcinomas and adenoid cystic carcinomas, indications for post-mastectomy RT in a retrospective Rare Cancer Network study, and reported incidences of local recurrences following mastectomy alone: 21.4% and 22.2%.
Our patient with adenoid cystic carcinoma of the breast, treated with surgery and adjuvant radiation therapy, showed favorable outcomes after 6 years.
Human ; Female ; Middle Aged: 45-64 Yrs Old ; Carcinoma, Adenoid Cystic ; Breast Neoplasms
2.Globe-sparing surgery and adjuvant radiotherapy for lacrimal gland adenoid cystic carcinoma in a 37-year-old Filipino female.
Lexus Neil P. Cahimat ; Maria Donna D. Santiago
Philippine Journal of Ophthalmology 2026;51(1):42-47
OBJECTIVE
To report a case of lacrimal gland adenoid cystic carcinoma in a 37-year-old female managed with globe-sparing surgery and adjuvant radiotherapy.
METHODSThis is a case report.
CASE PRESENTATIONThis report details a 37-year-old Filipino female who presented with a 4-month history of right eye pain and non-axial proptosis. Computed tomography (CT) scan showed a right heterogenous extraconal mass with orbital roof remodeling. Lateral orbitotomy with excision biopsy was performed. Final histopathologic diagnosis of adenoid cystic carcinoma of the lacrimal gland was made based on the classic morphology and distinct arrangement of the neoplastic cells. Systemic surveillance revealed absence of metastases. Patient completed adjuvant radiotherapy four months post-operatively. Vision was preserved at 20/20 without signs of tumor recurrence five months post-operatively.
CONCLUSIONAdenoid cystic carcinoma is an aggressive lacrimal gland malignancy; hence, meticulous examination and high index of suspicion cannot be over-emphasized. Globe-sparing surgery with adjuvant radiotherapy could significantly preserve quality of life.
Human ; Female ; Adult: 25-44 Yrs Old ; Lacrimal Apparatus ; Lacrimal Gland ; Carcinoma, Adenoid Cystic ; Radiotherapy, Adjuvant ; Adenoids
3.Fire in the Gland: A Rare Case of Graves' Disease in Cystic Fibrosis
Mohd Deenie Mohd Rodzhan ; Yik Hin Chin ; Norasyikin A. Wahab ; Norlaila Mustafa ; Ilham Ismail ; Mahrunissa Mahadi
Journal of the ASEAN Federation of Endocrine Societies 2026;41(S1):114-115
Introduction:
Cystic fibrosis (CF) is an autosomal recessive disorder
caused by mutations in the CFTR gene. Complications
such as cystic fibrosis–related diabetes (CFRD) are well
recognized. The association between CF and autoimmune
thyroid disease, however, is rare and poorly understood.
We report a case of CFRD complicated by Graves’ disease.
Case:
A 22-year-old male was diagnosed with CF at age 5,
confirmed by a positive sweat chloride test. Following
the diagnosis, lifelong pancreatic enzyme replacement
therapy (Creon) was initiated to treat exocrine pancreatic
insufficiency. In 2021, he developed type 3c diabetes,
attributed to endocrine pancreatic insufficiency, and
required regular basal insulin therapy.
In early 2024, he developed hypokalemic periodic paralysis
with proximal myopathy, despite potassium correction, and
was admitted to the hospital. On admission, examination
revealed a fine tremor and diffuse bilateral neck swelling.
Biochemical evaluation showed thyrotoxicosis with Free
T4 of 37 pmol/L and thyroid-stimulating hormone (TSH)
<0.01 mIU/L. He started a tapering dose of carbimazole
and propranolol. An urgent neck ultrasound showed a
heterogeneous thyroid parenchyma with increased vascularity and no nodules. Elevated anti-thyroid peroxidase
(anti-thyroid peroxidase, >600 IU/mL) and TSH receptor
antibodies (thyrotropin receptor antibody, 2.57 IU/L)
confirmed a diagnosis of Graves’ disease. During follow-ups, he had issues with compliance with the
antithyroid therapy. However, the latest thyroid function
test in February 2026 showed Free T4 of 20.5 pmol/L with
suppressed TSH of <0.01 mIU/L. He remains clinically
euthyroid throughout the follow-up.
Conclusion
This case highlights a rare but clinically relevant coexistence. Clinicians managing symptomatic CF patients should
vigilantly screen for thyroid dysfunction to ensure early
diagnosis and timely intervention. Early recognition and
treatment may improve patient outcomes. Further research
is needed to clarify the immunological link between CF
and autoimmunity.
Cystic Fibrosis
;
Graves Disease
4.Adenoid cystic carcinoma of the maxillary sinus and lateral skull base was removed and the submental artery island flap repaired the hard palate: a case report.
Pengchong GAO ; Sai WANG ; Yangtuo LUO ; Ning ZHAO ; Xuexin TAN ; Zhongyun MIN ; Hongquan WEI
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2025;39(1):84-90
Adenoid cystic carcinoma is a malignant tumor of the head and neck, this article reports a case of a large adenoid cystic carcinoma of the skull base, with the lesion involving the sphenoid sinus, sphenoid bone wings, pterygopalatine fossa, nfratemporal fossa, hard palate, and other structures. The treatment plan consisted of surgical excision, primary reconstrction of the surgical defect,and postoperative radiotherapy, resulting in a favorable prognosis for the patient.
Humans
;
Carcinoma, Adenoid Cystic/surgery*
;
Maxillary Sinus/surgery*
;
Maxillary Sinus Neoplasms/surgery*
;
Palate, Hard/surgery*
;
Skull Base Neoplasms/surgery*
;
Surgical Flaps
5.Transmembrane protein 16A--a new target for the treatment of airway inflammatory diseases.
Qiulan LUO ; Ningcong XU ; Xi TAN
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2025;39(6):590-596
One of the main pathological features of airway inflammatory diseases is hypersecretion of airway mucus, which is manifested by goblet cell hyperplasia and mucociliary clearance dysfunction. In recent years, it has been found that the molecular structure of calcium activated chloride ion channels, transmenbrane protein 16A(TMEM16A), is closely related to airway mucus hypersecretion.TMEM16A not only mediates ion transepithelial transport and hydration, but also participates in the regulation of mucin secretion. TMEM16A is highly expressed in airway epithelium of a variety of inflammatory diseases of upper and lower airway, such as asthma, cystic fibrosis, allergic rhinitis, chronic sinusitis and so on. Understanding the expression level and regulation mechanism of TMEM16A in different airway diseases and revealing its physiological function and pathological mechanism is critical for targeted disease treatment. This paper summarizes the research status of the discovery process, structural characteristics and regulatory mechanism of TMEM16A, and then summarizes the expression level of TMEM16A in asthma, cystic fibrosis, allergic rhinitis and chronic sinusitis ant related pathological mechanisms, clarifies the potential value of TMEM16A as a therapeutic target for the above four diseases, in order to guide treatment of airway inflammatory diseases.
Humans
;
Asthma/metabolism*
;
Anoctamin-1
;
Cystic Fibrosis/metabolism*
;
Neoplasm Proteins/metabolism*
;
Sinusitis/metabolism*
;
Chloride Channels/metabolism*
;
Rhinitis, Allergic/metabolism*
;
Inflammation
6.Recurrent eosinophilia with a novel homozygous ARPC1B mutation.
Gamze SONMEZ ; Baris ULUM ; Ates Kutay TENEKECI ; Canan CAKA ; Ali ŞAHIN ; Alp KAZANCIOĞLU ; Begum OZBEK ; İsmail YAZ ; Saliha ESENBOĞA ; Deniz ÇAĞDAŞ
Frontiers of Medicine 2025;19(1):174-180
Cytoskeletal network dysregulation is a pivotal determinant in various immunodeficiencies and autoinflammatory conditions. This report reviews the significance of actin remodeling in disease pathogenesis, focusing on the Arp2/3 complex and its regulatory subunit actin related protein 2/3 complex subunit 1B (ARPC1B). A spectrum of cellular dysfunctions associated with ARPC1B deficiency, impacting diverse immune cell types, is elucidated. The study presents a patient featuring recurrent and persistent eosinophilia attributed to homozygous ARPC1B mutation alongside concomitant compound heterozygous cystic fibrosis transmembrane conductance regulator (CFTR) gene mutations. We used ARPC1B antibody to stain the patient's peripheral blood lymphocytes and those of the control. The defect in the ARPC1B gene in the present patient caused absent/low expression by immunofluorescence microscopy. The intricate interplay between cytoskeletal defects and immunological manifestations underscores the complexity of disease phenotypes, warranting further exploration for targeted therapeutic strategies.
Humans
;
Actin-Related Protein 2-3 Complex/genetics*
;
Cystic Fibrosis Transmembrane Conductance Regulator/genetics*
;
Eosinophilia/genetics*
;
Homozygote
;
Mutation
;
Recurrence
7.Cystic fibrosis-causing variants in Chinese patients with congenital absence of the vas deferens: a cohort and meta-analysis.
Yi LU ; Jing WANG ; Zhong-Lin CAI ; Teng-Yan LI ; Hong-Jun LI ; Bin-Bin WANG
Asian Journal of Andrology 2025;27(5):611-620
Individuals with congenital absence of the vas deferens (CAVD) may transmit cystic fibrosis (CF)-causing variants of the cystic fibrosis transmembrane conductance regulator ( CFTR ) gene to their offspring through assisted reproductive technology (ART). We aimed to delineate the spectrum and estimate the prevalence of CF-causing variants in Chinese individuals with CAVD through a cohort analysis and meta-analysis. CFTR was sequenced in 145 Chinese individuals with CAVD. CFTR variants were classified as CF-causing or non-CF-causing variants regarding clinical significance. A comprehensive genotype analysis was performed in Chinese individuals with CAVD, incorporating previous studies and our study cohort. The prevalence of CF-causing variants was estimated through meta-analysis. In our cohort, 56 different CFTR variants were identified in 108 (74.5%) patients. Twenty variants were categorized as CF-causing and were detected in 28 (19.3%) patients. A comprehensive genotype analysis of 867 patients identified 174 different CFTR variants. Sixty-four were classified as CF-causing variants, 56.3% of which had not been previously reported in Chinese patients with CF. Meta-analysis showed that 14.8% (95% confidence interval [CI]: 11.0%-18.9%) CAVD cases harbored one CF-causing variant, and 68.6% (95% CI: 65.1%-72.0%) CAVD cases carried at least one CFTR variant. Our study underscores the urgent need for extensive CFTR screening, including sequencing of whole exons and flanking regions and detection of large rearrangements and deep intronic CF-causing variants, in Chinese individuals with CAVD before undergoing ART. The established CF-causing variants spectrum may aid in the development of genetic counseling strategies and preimplantation diagnosis to prevent the birth of a child with CF.
Adult
;
Humans
;
Male
;
China
;
Cohort Studies
;
Cystic Fibrosis/genetics*
;
Cystic Fibrosis Transmembrane Conductance Regulator/genetics*
;
Genotype
;
Male Urogenital Diseases/genetics*
;
Mutation
;
Vas Deferens/abnormalities*
;
East Asian People/genetics*
8.Identification of a novel deep intronic variant associated with Joubert syndrome through combined whole-genome sequencing and RNA sequencing.
Fang LIU ; Yan JIANG ; Xin GUI ; Yangxue XIAO ; Xiaohang ZHANG ; Xuemei ZHANG ; Yali GAO
Chinese Journal of Medical Genetics 2025;42(5):597-602
OBJECTIVE:
To explore the genetic etiology of a Chinese pedigree with recurrent Joubert syndrome with negative results by whole-exome sequencing in the prior proband.
METHODS:
Chinese pedigree which opted elective abortion at the Women and Children's Hospital Affiliated to Chongqing Medical University in December 2024 was selected as the study subject. Whole-genome sequencing was carried out on fetal tissue after termination of pregnancy. Candidate variants were validated by Sanger sequencing and interpreted, while non-coding variant was analyzed using in silico prediction tools. RNA sequencing and cDNA sequencing were conducted on fetal brain tissue. This study was approved by the Medical Ethics Committee of the Hospital (Ethics No.2024YL045-02).
RESULTS:
Both the fetus and the affected child were found to harbor compound heterozygous variants of the CEP290 gene, namely c.7341dup (p.Leu2448fs*8) (pathogenic, maternally inherited) and c.1523-408G>A (likely pathogenic, paternally inherited). Both in silico analysis and fetal brain RNA sequencing confirmed aberrant RNA splicing caused by the intronic variant.
CONCLUSION
This case has highlighted the value of combining whole-genome sequencing with RNA functional validation. Above results not only enriched the spectrum of CEP290 gene mutations but also underscored its diagnostic value in resolving complex prenatal cases, providing critical clues for the prenatal diagnosis and recurrence risk assessment in genetic counseling.
Female
;
Humans
;
Pregnancy
;
Abnormalities, Multiple/genetics*
;
Antigens, Neoplasm/genetics*
;
Cell Cycle Proteins/genetics*
;
Cerebellum/abnormalities*
;
Cytoskeletal Proteins/genetics*
;
Eye Abnormalities/genetics*
;
Introns/genetics*
;
Kidney Diseases, Cystic/diagnosis*
;
Pedigree
;
Retina/abnormalities*
;
Sequence Analysis, RNA/methods*
;
Whole Genome Sequencing/methods*
;
Child
9.Common characteristics and regulatory mechanisms of airway mucus hypersecretion in lung disease.
Ze-Qiang LIN ; Shi-Man PANG ; Si-Yuan ZHU ; Li-Xia HE ; Wei-Guo KONG ; Wen-Ju LU ; Zi-Li ZHANG
Acta Physiologica Sinica 2025;77(5):989-1000
In a healthy human, the airway mucus forms a thin, protective liquid layer covering the surface of the respiratory tract. It comprises a complex blend of mucin, multiple antibacterial proteins, metabolic substances, water, and electrolytes. This mucus plays a pivotal role in the lungs' innate immune system by maintaining airway hydration and capturing airborne particles and pathogens. However, heightened mucus secretion in the airway can compromise ciliary clearance, obstruct the respiratory tract, and increase the risk of pathogen colonization and recurrent infections. Consequently, a thorough exploration of the mechanisms driving excessive airway mucus secretion is crucial for establishing a theoretical foundation for the eventual development of targeted drugs designed to reduce mucus production. Across a range of lung diseases, excessive airway mucus secretion manifests with unique characteristics and regulatory mechanisms, all intricately linked to mucin. This article provides a comprehensive overview of the characteristics and regulatory mechanisms associated with excessive airway mucus secretion in several prevalent lung diseases.
Humans
;
Mucus/metabolism*
;
Mucins/physiology*
;
Lung Diseases/metabolism*
;
Respiratory Mucosa/metabolism*
;
Pulmonary Disease, Chronic Obstructive/physiopathology*
;
Asthma/physiopathology*
;
Cystic Fibrosis/physiopathology*
;
Mucociliary Clearance/physiology*
10.An innovative airway management of an anticipated difficult airway in a pediatric patient with cervical cystic hygroma: A case report
Evangeline K. Villa ; Niñ ; o Anthony S. Samar
Acta Medica Philippina 2024;58(9):30-34
Airway management of a pediatric patient with cervical cystic hygroma can be challenging as the large neck mass may extend in the oral cavity, result in tracheal deviation, and cause possible upper airway obstruction. This is a case of a 4-year-old female admitted due to sudden enlargement of neck mass associated with dysphagia and sialorrhea. Patient was intubated under sedation while maintaining spontaneous ventilation with a pediatric flexible fiberoptic scope through a nasopharyngeal airway serving as a passage guide for ease of scoping and a protective device against trauma.
Lymphangioma, Cystic
;
Airway Management
;
Intubation


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