{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T11:08:17Z","timestamp":1784632097657,"version":"3.55.0"},"reference-count":32,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,5,18]],"date-time":"2026-05-18T00:00:00Z","timestamp":1779062400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Oncol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Pulmonary adenoid cystic carcinoma (PACC) is a rare salivary gland-type malignancy, accounting for 0.04%\u20130.2% of primary lung neoplasms. The solid variant with pleural metastasis and malignant pleural effusion is exceptionally uncommon, posing significant diagnostic and therapeutic challenges.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case presentation<\/jats:title>\n                    <jats:p>We report a 65-year-old man whose lung biopsy was initially interpreted as squamous cell carcinoma without keratinization in the setting of basaloid morphology and p40\/p63 positivity. The diagnosis was revised to solid-variant primary PACC after an expanded immunohistochemical workup demonstrated biphasic epithelial\u2013myoepithelial differentiation, including expression of SOX10 and c-Myb. Given the advanced stage, the patient received a systemic combination of tislelizumab, cyclophosphamide, pegylated liposomal doxorubicin, and nedaplatin, initially combined with local intrapleural therapy. This treatment was followed by a partial response and marked symptomatic improvement without grade \u22653 treatment-related adverse events.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This case highlights a diagnostic pitfall in lung tumors exhibiting squamoid immunophenotypes and underscores the necessity of incorporating myoepithelial markers into the diagnostic workup. Furthermore, it provides a cautiously interpreted clinical observation of immune checkpoint inhibitor\u2013based combination therapy in advanced PACC.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fonc.2026.1827108","type":"journal-article","created":{"date-parts":[[2026,5,18]],"date-time":"2026-05-18T04:17:30Z","timestamp":1779077850000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Solid-variant primary pulmonary adenoid cystic carcinoma with pleural metastasis and malignant pleural effusion: a rare case report"],"prefix":"10.3389","volume":"16","author":[{"given":"Suyi","family":"Guo","sequence":"first","affiliation":[{"name":"Shaanxi University of Chinese Medicine","place":["Xianyang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yang","family":"Zhai","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Shaanxi Provincial Cancer Hospital","place":["Xi\u2019an, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hongbian","family":"Gao","sequence":"additional","affiliation":[{"name":"Department of Pathology, Shaanxi Provincial Cancer Hospital","place":["Xi\u2019an, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caixia","family":"Ding","sequence":"additional","affiliation":[{"name":"Department of Pathology, Shaanxi Provincial Cancer Hospital","place":["Xi\u2019an, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,5,18]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1016\/j.oraloncology.2015.04.005","article-title":"Adenoid cystic carcinoma of the head and neck\u2013an update","volume":"51","author":"Coca-Pelaz","year":"2015","journal-title":"Oral Oncol"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1111\/1759-7714.15202","article-title":"Primary pulmonary adenoid cystic 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