To highlight diagnostic challenges and provide clinical evidence for treatment in a rare case of solid-variant primary pulmonary adenoid cystic carcinoma (PACC) with pleural metastasis, emphasizing its significance in the context of existing literature.
Key Findings:
Initial diagnosis was squamous cell carcinoma; revised to solid-variant PACC after immunohistochemical analysis.
Patient presented with pleural metastasis and malignant pleural effusion.
Treatment resulted in partial response and symptomatic improvement without severe adverse events.
Interpretation:
The case underscores the importance of myoepithelial markers in differentiating solid-variant PACC from squamous cell carcinoma, particularly in small biopsy specimens, and suggests potential changes in diagnostic protocols.
Limitations:
Limited evidence-based therapeutic strategies for advanced PACC, such as the lack of randomized controlled trials.
No established standard systemic treatment for advanced cases, highlighting the need for further research.
Conclusion:
This case illustrates a rare presentation of solid-variant PACC and suggests the potential of immune checkpoint inhibitor-based combination therapy in advanced disease.
