Adenoid cystic carcinoma of the head and neck

Abstract

Adenoid cystic carcinoma has a long natural history but frequently proves fatal. The present study describes 108 patients with an adenoid cystic carcinoma of the head and neck seen over a 30-year period. Analysis of the data utilized both univariate and multivariate methods. Forty per cent of patients had tumours arising from the oral cavity and half of these were in the hard palate; 29% occurred in the major salivary glands; 41% of tumours were locally advanced at presentation and 11% had lymph node metastases at this time. The histological pattern was solid in 25%, cribriform in 40% and tubular in 20%. In addition, 15% of patients had a polymorphous low-grade adenocarcinoma and these were analysed separately. Primary site recurrence was more common in the presence of locally advanced tumours at presentation (T3-4) (P = 0.0093). Only six patients had surgery with adjuvant radiotherapy. Six patients had no curative treatment, 21 had primary radiotherapy, 39 had local excision and 42 radical excision. The actuarial primary site recurrence rate was 100% at 30 years. The neck node recurrence rate was 23% at 15 years. Tumour specific survival was 40% at 20 years. Solid histology had a worse prognosis than other histological types (P = 0.0429) but those patients with polymorphous low-grade adenocarcinomas fared very well. Patients with tumours of the hard palate fared better than those patients with tumours at other sites (P = 0.0301). Early disease at the primary site (T1-2) was a good prognostic sign (P = 0.0013). Patients with neck node metastases at presentation tended to do badly (P = 0.009).

Clinicopathological Review and Survival Characteristics of Adenoid Cystic Carcinoma

“…Additionally, we did not find that increased age was associated with increased recurrence rate or overall survival which is in contrast with other study [20]. Jones et al [21] reported that males with primary adenoid cystic carcinomas of the head and neck had a significantly better prognosis than females, while our results indicated that females had a better disease-specific survival. Consistent with other study positive surgical margin was a strong prognostic factor [9].Meanwhile, one study showed the adequacy of surgical resection did not seem to influence overall survival or recurrence rate [16].…”

Sialolith and adenoid cystic carcinoma in the submandibular gland. A rare case

“…Adenoid cystic carcinoma can occur in any salivary gland, but approximately 50% develop within the minor salivary glands with parotid the most common site of occurrence (11). In the submandibular gland, this tumor accounts for 12% to 17% of all tumors (12). A possibility of tumor was ruled out for this patient because swelling, pain and paresthesia were not constant and a radiopaque nodule was detected in OPG.…”

Mystery in parotid

“…Perineural invasion is a typical feature, with high frequency of pain. 17 Salivary duct adenocarcinoma is a rare and highly aggressive tumor with solid, tubular and cribriform patterns, that closely resemble invasive ductal carcinoma of the breast. It is rare high-grade form, aggressive with frequent metastases.…”