Atypical Chest Pain as a Prelude to Cancer: An Uncommon Presentation of Adenoid Cystic Carcinoma of the Parotid Gland
Bibliographic record
Abstract
Adenoid cystic carcinoma (ACC) of the parotid gland is a rare malignancy characterized by delayed distant metastasis, often presenting as pre-auricular swelling. We report a 47-year-old male who initially presented with unexplained right-sided chest pain, leading to the discovery of a rib lesion and eventual diagnosis of metastatic ACC. Imaging revealed a parotid mass and metastatic involvement of the ribs, confirmed by biopsy. A left subtotal parotidectomy was performed, with histopathological examination confirming ACC. The patient received adjuvant radiotherapy and is stable with no recurrence at the 6-month follow-up. This case underscores the importance of considering head and neck cancers, including ACC, in patients with unexplained chest pain, especially those with a history of salivary gland tumours. Despite ACC's relatively low rate of regional lymph node metastasis, its propensity for distant metastasis, including to uncommon sites such as the ribs, highlights the need for a systematic approach in evaluating atypical presentations. Early detection through self-examination, clinical vigilance, and imaging modalities like PET-CT can significantly improve outcomes. Prolonged surveillance is crucial due to the risk of delayed metastasis. Prompt management in patients with atypical symptoms, such as chest pain, is essential for improving prognosis and patient survival.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.004 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.002 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.003 | 0.002 |
| Insufficient payload (model declined to judge) | 0.003 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".