Background

Ceruminous glands are modified apocrine glands of the external auditory canal (EAC). Malignant tumours within the ceruminous glands are extremely rare, and the most common histological type is adenoid cystic carcinoma (ADCC), which has high recurrence and metastasis risks. Although a few cases of metastatic ADCC from other head and neck glands have been reported, metastatic ADCC originating from the ceruminous gland are extremely rare.

Case presentation

We present an unusual case of spinal metastases of ADCC from ceruminous glands. A 61-year-old woman complaining of low back pain and both lower limbs pain was referred to our department. The primary ceruminous tumour was resected 26 years ago and recurred 6 years later, which was treated by radiotherapy. Three years ago, she presented with low back pain and was diagnosed as multiple lungs and bone metastases. The patient underwent tumour excision, decompression and fusion. The biopsy revealed metastatic ADCC. The symptoms were alleviated after surgery.

Conclusions

ADCC of EAC is a pernicious malignant tumour that is characterized by slow-growing patterns and a high predisposition to recurrence and metastasis. Differential diagnoses of ADCC and benign tumours in the EAC are challenging, particularly at early stages. We report a rare case of ceruminous ADCC with a prolonged clinical history as well as spinal metastasis and highlight the significance of regular follow-ups for patients undergoing tumour excision in the EAC.

中文翻译：

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腰椎转移性耵聍腺样囊性癌导致神经功能损害：病例报告

背景

耵聍腺是外耳道 (EAC) 的改良顶泌腺。耵聍腺内的恶性肿瘤极为罕见，最常见的组织学类型是腺样囊性癌（ADCC），具有很高的复发和转移风险。尽管已经报道了少数来自其他头颈部腺体的转移性 ADCC 病例，但来自耵聍腺的转移性 ADCC 极为罕见。

案例展示

我们提出了一个罕见的从耵聍腺发生的 ADCC 脊柱转移病例。一位 61 岁的女性主诉腰痛和双下肢疼痛，被转诊到我科。26年前原发耵聍瘤切除，6年后复发，放疗治疗。三年前，她出现腰痛，被诊断为多发性肺和骨转移。患者接受了肿瘤切除、减压和融合术。活检显示转移性ADCC。手术后症状有所缓解。

结论

EAC 的 ADCC 是一种恶性的恶性肿瘤，其特点是生长缓慢，易复发和转移。EAC 中 ADCC 和良性肿瘤的鉴别诊断具有挑战性，尤其是在早期阶段。我们报告了一个罕见的具有长期临床病史和脊柱转移的耵聍 ADCC 病例，并强调了定期随访对在 EAC 进行肿瘤切除的患者的重要性。