Adenoid Cystic Carcinoma of the Breast and Uterine Cervix: Two Rare Extraglandular Presentations

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Background: Adenoid cystic carcinoma is a rare malignant epithelial tumor most frequently arising in the salivary glands. Primary involvement of the breast or uterine cervix is exceptional. Although these tumors share similar histological features, their clinical behavior and therapeutic management differ substantially according to the primary site. Case presentations: We report two cases of primary adenoid cystic carcinoma occurring at unusual extraglandular sites. The first patient was a 78-year-old woman diagnosed with a 1.6-cm solid-variant adenoid cystic carcinoma of the breast. The tumor showed a triple-negative phenotype, a Ki-67 proliferation index of 50%, The patient underwent breast-conserving surgery consisting of a right partial mastectomy close surgical margin of less than 1 mm, and no sentinel lymph node involvement. The pathological stage was pT1cN0M0. She underwent breast-conserving surgery, adjuvant chemotherapy with three cycles of EC100 followed by three cycles of paclitaxel, and three-dimensional conformal radiotherapy to a total dose of 42 Gy in 15 fractions. The second patient was a 70-year-old woman diagnosed with a 3-cm adenoid cystic carcinoma of the uterine cervix. She underwent total colpohysterectomy with bilateral pelvic lymph node dissection. Final histopathological examination revealed full-thickness cervical stromal invasion, lymphovascular space invasion, positive surgical margins, and tumor involvement of the parametria and anterior vaginal cuff. None of the 17 removed pelvic lymph nodes showed metastatic involvement. The tumor was classified as FIGO stage IIB. Given the positive surgical margins, parametrial involvement, and the impossibility of further surgical resection, postoperative concomitant chemoradiotherapy was administered using volumetric modulated arc therapy to a total dose of 66 Gy, combined with weekly cisplatin at 40 mg/m². At 3 years of follow-up, both patients remained under satisfactory disease control, with no

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