Abstract
ABSTRACT A 52-year-old male patient complained of loss of sensitivity and pain in the maxilla. After examination, root canal treatment of tooth 12 was requested. Subsequently, there was a purplish increased volume of softened consistency in the area of vestibular attached gingiva of tooth 12. The anterior upper dental segment presented mobility. Incisional biopsy revealed malignant neoplasm of glandular epithelial origin, suggestive of solid adenoid cystic carcinoma (ACC). An immunohistochemical panel was performed, which confirmed the histopathological suspicion. Solid ACC may lead to diagnostic difficulties, since this lesion exhibits morphological features similar to other malignancies.
Highlights
IntroductionAdenoid cystic carcinoma (ACC) in the oral cavity, commonly arises from the minor salivary glands of the hard palate, usually affecting patients after the fourth decade of life and showing a predilection for the female gender(1, 2)
Adenoid cystic carcinoma (ACC) in the oral cavity, commonly arises from the minor salivary glands of the hard palate, usually affecting patients after the fourth decade of life and showing a predilection for the female gender(1, 2).ACC usually exhibits a slow-growing increased volume, sometimes ulcerated, and bone destruction may occur at moreadvanced stages(3, 4)
ACC are composed of myoepithelial cells and ductal cells exhibiting angular, hyperchromatic nuclei and clear cytoplasm, arranged in a stroma of dense fibrous connective tissue
Summary
Adenoid cystic carcinoma (ACC) in the oral cavity, commonly arises from the minor salivary glands of the hard palate, usually affecting patients after the fourth decade of life and showing a predilection for the female gender(1, 2). ACC usually exhibits a slow-growing increased volume, sometimes ulcerated, and bone destruction may occur at moreadvanced stages(3, 4). The solid ACC pattern presents small, cuboidal, basophilic cells with little cytoplasm and is related to a worse prognosis, due to the high rate of tumor invasion, high ability for distant metastasis, that usually occurs in the lungs, and high potential for relapse(1, 5). The solid ACC pattern is similar to other epithelial neoplasms(2, .6-9) immunohistochemistry can assist the pathologist at the diagnosis. In this context, the present study aims to report a case of ACC with solid pattern in an adult patient, focusing on the immunohistochemical profile and differential diagnosis of this neoplasm
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