Abstract

A 55-year-old male patient attended a dermatology center because of dysarthria and dysphagia. The clinical examination showed swelling in the base of the tongue extending bilaterally to the borders preserving the median longitudinal groove. The patient underwent punch biopsy, and the specimen was referred for anatomopathologic examination with clinical suspicion of hypertrophy of tongue. Histopathologic examination revealed malignant neoplasm of glandular origin composed of cells with scarce eosinophilic cytoplasm and large hyperchromatic nuclei, organized in nests and cords sometimes with cribriform pattern and luminal formation filled with homogeneous eosinophilic material. The morphologic characteristics suggested a diagnosis of adenoid cystic carcinoma (ACC) or metastatic tumor. The immunohistochemical study demonstrated that epithelial/ductal cells were positive for cytokeratins and basal cells for p63 protein revealing their myoepithelial origin, with membrane epithelial antigen being focally positive, which led to the diagnosis of ACC. The patient was referred to an oncologic reference center.

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