A cribriform cylindroma with metastases.

Abstract

Bilroth coined the term, “cylindroma” in 1859 when he described a tumour with a distinctive histological pattern of cylinders of cells alternating with hyaline material arranged round a central cavity which may contain mucus (Annotation, Lancet, 1956). This tumour may arise in the major or minor salivary glands, in the mucus secreting glands of the oral cavity, the paranasal air sinuses, the nasopharynx, pharynx, lacrimal glands, trachea, bronchi, skin or breast (Foote and Frazell, 1954). The term cylindroma is now reserved for the tumour arising in the salivary glands. Cribriform cylindroma or adenoid cystic carcinoma is the most malignant variety and has a bad prognosis. This tumour is reputed to be radio-resistant, recurrence is common and metastases are frequent. In the rapidly growing variety of cylindromas the ducts disappear and instead groups of spherical holes appear within masses of small dark staining cells producing a cribriform pattern (Lennox, 1960). Harrison (1956) in a study of ectopic mixed salivary tumours, found cylindromas arising more commonly in ectopic sites, two thirds outside the major salivary glands. Three-quarters of the cases occurred between the ages of 30 and 70 years. All the tumours at the base of the tongue (six out of 46 cases) in his series were cylindromas. He found frank local recurrence in ten out of 46 cases of cylindroma; nine patients had cervical node metastases and a further six had metastases to the viscera and skeleton.