Adenoid Cystic Carcinoma Of Minor Salivary Glands Research Articles

ADENOID CYSTIC CARCINOMA OF MINOR SALIVARY GLANDS: A 10-YEAR SINGLE-CENTER RETROSPECTIVE STUDY

Objective The aim of this study was to evaluate the clinicopathologic features of adenoid cystic carcinoma of minor salivary glands (ACC-MSG) from a single Brazilian Oral Pathology Laboratory. Study Design Clinical data and conventionally stained slides of all cases diagnosed as ACC-MSG between 2012 and 2021 were retrieved from the Laboratory files and microscopically reviewed. Results There were 23 cases of ACC-MSG in the last 10 years (2.3 cases/year) affecting 16 women (69.6%) and 7 men (30.4%) (mean age of 53 years). The palate was the most affected site (10 cases, 43.5%), followed by the floor of mouth (5 cases, 21.7%), buccal mucosa (3 cases, 13%), and tongue (3 cases, 13%). The main clinical presentation was of a nodule (16 cases; 69.6%), 4 of which displaying an ulcerated surface. Four cases appeared as ulcers (17.4%). Pain was reported in 12 cases (52.2%). Microscopically, 12 cases (52.2%) showed both cribriform and tubular patterns, while focal solid areas were observed in 14 cases (60.9%). Ten cases (43.5%) exhibited perineural invasion, and a single case showed necrosis. Conclusion The clinicopathologic profile of ACC-MSG in this Brazilian population is similar to previous studies. Approximately half of the cases exhibited pain and perineural invasion. The aim of this study was to evaluate the clinicopathologic features of adenoid cystic carcinoma of minor salivary glands (ACC-MSG) from a single Brazilian Oral Pathology Laboratory. Clinical data and conventionally stained slides of all cases diagnosed as ACC-MSG between 2012 and 2021 were retrieved from the Laboratory files and microscopically reviewed. There were 23 cases of ACC-MSG in the last 10 years (2.3 cases/year) affecting 16 women (69.6%) and 7 men (30.4%) (mean age of 53 years). The palate was the most affected site (10 cases, 43.5%), followed by the floor of mouth (5 cases, 21.7%), buccal mucosa (3 cases, 13%), and tongue (3 cases, 13%). The main clinical presentation was of a nodule (16 cases; 69.6%), 4 of which displaying an ulcerated surface. Four cases appeared as ulcers (17.4%). Pain was reported in 12 cases (52.2%). Microscopically, 12 cases (52.2%) showed both cribriform and tubular patterns, while focal solid areas were observed in 14 cases (60.9%). Ten cases (43.5%) exhibited perineural invasion, and a single case showed necrosis. The clinicopathologic profile of ACC-MSG in this Brazilian population is similar to previous studies. Approximately half of the cases exhibited pain and perineural invasion.

Matrix metalloproteinase-7, -8, -9, -15, and -25 in minor salivary gland adenoid cystic carcinoma

Knowledge on the role of matrix metalloproteinases (MMPs) in adenoid cystic carcinoma (ACC) is limited. MMPs are capable of degrading almost all extracellular and pericellular components to promote invasion and metastasis. This study aimed to evaluate the immunohistochemical expression of MMP-7, -8, -9, -15, and -25 in ACC and to relate the results with clinicopathological factors and survival.The study included 68 patients with minor salivary gland ACC treated at the Helsinki University Hospital (Helsinki, Finland) in 1974–2012. Samples from 52 patients were available, consisting of 44 primary tumours and eight recurrent tumours. We scored immunostaining of MMP-7, -8, -9, -15, and -25 and analysed the immunoscore against clinical and pathological parameters using statistical correlation test.MMP-9 immunoexpression in pseudocysts of ACC and in peritumoural inflammatory cells associated with better survival and fewer treatment failures. High tumoural MMP-7 and -25 associated with better survival. High tumoural MMP-15 associated with poorer survival and high tumoural MMP-9 with advanced stage and regional recurrences. Tumour cells did not show MMP-8 immunopositivity.These results suggest that MMP-9 may contribute to ACC carcinogenesis in different roles. MMP-7, -8, and -9 can stimulate signalling pathways that may promote tissue modulation and metastatic potential. MMP-15 and -25 may reflect prognosis.

Neck involvement and disease recurrence in adenoid cystic carcinoma of the minor salivary glands: the role of surgery in primary and progressive disease

The aim of this study was to analyse the rates of metastatic events and clinical outcomes of patients with adenoid cystic carcinoma (ACC) of the minor salivary glands and to critically evaluate the role of surgical therapy. A retrospective cohort study was designed including all patients with ACC of the oral minor salivary glands treated in the study department during the years 2010–2017. Relevant clinicopathological data were analysed to determine factors with an impact on overall survival (OS) and progression-free survival (PFS). Forty-one patients with primary ACC of the oral cavity and the oropharynx were included. Cervical metastases were found in 14 patients (34.1%) and were shown to have a significant negative impact on OS (P=0.009) and PFS (P=0.03). Sixteen patients developed disease recurrence during follow-up (39.0%) and most patients exhibited local disease recurrence with or without regional or distant metastases (14/16, 87.5%). Local recurrence was treated successfully with surgery in five cases. We recommend surgical therapy for patients with ACC of the minor salivary glands, including elective neck dissection and microvascular reconstruction, to optimize the planning of adjuvant therapy.

Clinicopathological profile of adenoid cystic carcinoma of minor salivary gland tumour: our experience at a tertiary care centre

<p class="abstract"><strong>Background:</strong> Adenoid cystic carcinoma (ACC) is a rare malignant tumour originating from minor salivary glands. It is known for perineural spread, local recurrences and distant metastasis. The minor salivary gland tumour represents 3% of all head and neck neoplasms, whereas ACC constitutes about 0.5% of all malignant salivary gland neoplasms. This study was done to evaluate the clinical presentation and histopathological findings of minor salivary gland tumour.</p><p class="abstract"><strong>Methods:</strong> This study was done in the department of ENT, Bangalore Medical College and Research Institute from May 2017 to July 2019. Of the 25 patients with minor salivary gland tumour, 10 patients with ACC were considered for the present study. A detailed clinical and histopathological evaluation was done. Results were documented and tabulated in excel sheet. </p><p class="abstract"><strong>Results:</strong> We analysed data of 25 (16 female, 9 male) patients in the age group of 30-60 years, of which 10 patients had adenoid cystic carcinoma of minor salivary gland tumour. The most frequent site of tumour occurrence was noted in the hard palate (6 patients), followed by retromolar trigone (2 patients), floor of mouth (1 patient) and tongue (1 patient). The histopathological pattern noted most commonly in our study: cribriform pattern (6 cases), tubular (1 case) and solid (3 cases).</p><p class="abstract"><strong>Conclusions:</strong> ACC of minor salivary glands is rare. The otorhinolaryngologist should bear this clinical entity in mind when encountered with a painless swelling over the hard palate. This would lead to an early diagnosis and prompt management in such patients.</p>

Intensity Modulated Radiotherapy (IMRT) + Carbon Ion Boost for Adenoid Cystic Carcinoma of the Minor Salivary Glands in the Oral Cavity

Background: Adenoid cystic carcinoma (ACC) are more common in the minor salivary glands (MiSGs) than the major salivary glands, and are characterized by slow tumor progression and frequently local recurrence. The main treatment option is surgery followed by combined radiotherapy. Methods: A retrospective analysis contained 67 patients with ACC of MiSGs in the oral cavity who underwent surgery followed by radiotherapy. The median cumulative IMRT dose was 50 Gy followed by 24 Gy for carbon ion (C12) boost. Median follow-up was 40 months. Results: Median 5-years overall survival (OS), progression-free survival (PFS) and local disease-free survival (LDFS) rates were 85.5%, 57.4% and 74.9%. Median time until progression was detected was 32 months (range: 2–205 months). Early grade ≥3 mucositis, dermatitis, and dysphagia were detected in 52.2%, 7.5% and 11.9% respectively. Besides common toxicities, two patients (3.0%) developed grade 3 toxicities with osteoradionecrosis of the jaw after 18 and 66 months. Higher-grade late toxicity (CTCAE grade 4) was not detected. No treatment-related death was detected. Conclusions: Our results demonstrate that postoperative combined radiotherapy with IMRT plus C12 boost seems to be a feasible and effective treatment method in ACC of MiSGs in the oral cavity, with good control and survival rates and adequate toxicity.

PP014: Comparison of oncologic outcomes between major and minor salviary gland adenoid cystic carcinoma (ACC)

Purposes The purpose of our study was to compare the oncologic outcome between major and minor salivary gland ACC during the 18-year follow-up. Materials and methods The records of 61 consecutive patients with ACC were reviewed. Thirty patients had major gland ACC and 31 patients had minor gland ACC. Stage I–II disease was found in 36 patients and stage III–IV disease was found in 25 patients. Surgical treatment was performed in all patients. Adjuvant treatment was applied if indicated. Results There were no significant differences in patients or tumor characteristics between major and minor gland ACC. Local and regional recurrence rates were similar ( Table 1 ). However, minor gland ACC had shorter duration of regional recurrence significantly. The overall survival rate was 79.8% at 5 years, 76.85% at 10 years and 64.04% at 15 years. Survival rate and duration were not different in both groups. However, when we compared the patients who had no evidence of disease (NED) status and who had alive with disease (AWD) status in survivors at the end of follow-up, minor gland ACC had more AWD status than major gland ACC significantly. Conclusions ACCs in minor salivary gland had more rapid regional recurrence, frequent distant metastasis and higher alive with disease status than ACCs in major salivary gland.

Concurrent occurrence of adenoid cystic carcinoma of the salivary glands with small cell carcinoma of the liver: A rare case report

Adenoid cystic carcinoma (ACC) is a clinically deceptive and histologically specific malignancy of salivary gland origin. It is the most common minor salivary gland malignancy. Small cell carcinoma (SCC) is a type of undifferentiated malignant neuroendocrine tumor reported rarely in the liver. Though there are many reported cases of SCC involving liver and ACC of minor salivary glands, the review of literature does not show any reports of concomitant occurrence of these two tumors. We describe a rare case of ACC of the oral cavity and its coexistence with a SCC involving liver, identified and confirmed by histological, and immunohistochemical observations. To our knowledge, this is the first reported case of an ACC of the oral cavity and SCC of liver occurring concomitantly in the same patient.

Fine-needle aspiration biopsy as an auxiliary diagnostic tool on intraoral minor salivary gland adenoid cystic carcinoma

Fine-needle aspiration biopsy (FNAB) is useful in diagnosis of major salivary gland adenoid cystic carcinoma (ACC), but it has been rarely reported on minor salivary gland ACC. The aim of this study was to report the utility of FNAB on diagnosis of ACC involving minor salivary glands. Three patients presenting ACC involving the palate (2 cases) and buccal mucosa (1 case), with a mean age of 36 years and 2:1 female-to-male ratio, were included in the study. All of the patients were submitted to FNAB for diagnostic purposes. All smears were stained with hematoxylin-eosin, Papanicolaou, and Diff-Quik and showed the presence of small polyhedral cells with hyperchromatic nuclei and extracellular basophilic globular amorphous substance, compatible with ACC. Diagnosis of the 3 cases was subsequently confirmed through histopathology. The FNAB was easy to perform and cost-effective, and proved to be an useful adjunctive tool in diagnosis of intraoral ACC.

Management of Adenoid Cystic Carcinoma of Minor Salivary Glands

Adenoid cystic carcinoma (ACC) is a rare malignant tumor originating from the salivary glands. The characteristic clinicopathologic features of this tumor are perineural spread, local recurrences, and distant metastases. Radical surgery combined with radiotherapy, as mentioned in the literature, is the best method of treatment. This clinical review article is intended to analyze the outcome of management of a group of 22 ACC patients, who were treated in our clinic. Between 1985 and 2000, 22 patients with ACC of minor salivary glands were treated in the Clinic of Oral and Maxillofacial Surgery of the "G. Papanikolaou" General Hospital, in Thessaloniki. The age range was 22 to 87 years. The distribution of the primary sites was buccal mucosa (3), floor of the mouth (1), hard palate (3), soft palate (2), junction of hard and soft palate (7), and hard or soft palate with spread in the paranasal sinus etc (6). All the patients were treated radically with surgery. The surgery was combined with radiotherapy in 17 patients. A total dose of 60 Gy in a 30- to 40-day period was given, using conventional 2 Gy fractions per day. Immunohistochemical assay of the expression of the Ki-67 antigen was performed on a subset of 15 cases. The mean follow-up range was 4 to 14 years. From the 22 patients, 15 (68.18%) were alive for more than 5 years and 6 (27.7%) had died from the disease. Eight patients were free of the disease for more than 5 years (ranging from 7 to 14), 4 patients were free of the disease for 5 years, and 3 patients were free of the disease for 4 years. One patient lived more than 10 years and died from another cause. Local recurrence was developed in 2 patients. One recurrence occurred within the first year after the treatment and the second local recurrence occurred 13 years after the initial treatment. Lymph node metastases occurred in 2 patients, 3 years and 7 years after completing the treatment. Distant metastases (lung) occurred in 2 patients, 2 years and 6 years after completing the treatment. The Mann-Whitney statistical analysis was used for comparing the Ki-67 values in correlation with prognosis and location of ACCs. The Ki-67 value was significantly higher in tumors from patients with treatment failure than in nonfailures (P < .001). The Ki-67 expression was also higher in large tumors characterized by wide topical spread (P < .005). The most proper method of treatment for ACC seems to be radical resection combined with radiotherapy. The treatment failure is associated with positive margins of the excised surgical specimen and named nerve involvement. The immunohistochemical study of Ki-67 expression may provide additional prognostic information for this tumor.

Management of salivary gland adenoid cystic carcinoma: institutional experience of a case series

Salivary gland tumor management requires long-term follow-up because of tumor indolence and possible late recurrence and distant metastasis. Adenoid cystic carcinoma (ACC) accounts for 10-15% of such tumors. The aim here was to evaluate surgical and clinical management, staging and follow-up of ACC patients in one academic institution. Retrospective study at Head and Neck Service, Universidade Estadual de Campinas. Data on 21 patients treated between 1993 and 2003 were reviewed. Management utilized clinical staging, histology and imaging. Major salivary gland tumor extent was routinely assessed by preoperative ultrasonography. Diagnosis, surgery type, margin type (negative/positive), postoperative radiotherapy and recurrence (presence/absence) were evaluated. There were eleven major salivary gland tumors (52.3%), seven submandibular and four parotid. Ten patients (47.7%) had minor salivary gland ACC (all in palate), while the submandibular was the most frequently affected major one. Diagnoses were mostly via fine-needle aspiration (FNA) and incision biopsy. Frozen sections were used for six patients. There was good ultrasound/FNA correlation. Sixteen (76%) had postoperative radiotherapy. One (4.7%) died from ACC and five now have recurrent disease: three (14.2%) locoregional and two (9.5%) distant metastases. Adenoid cystic carcinoma has locally aggressive behavior. In 21 cases, of ACC, the facial nerve was preserved in all except in the few with gross tumor involvement. Treatment was defined from physical examination, imaging, staging and histology.

Radiotherapy after surgery for advanced adenoid cystic carcinoma of paranasal sinus

Paranasal–sinus carcinoma and nasal-cavity carcinoma are fairly rare, representing about 3% of aerodigestive malignant disease. About 10–15% of paranasal-sinus cancers are minor salivary-gland tumours. Adenoid cystic carcinoma is a fairly uncommon malignant disease that accounts for about 22% of all salivary-gland cancers, and occurs most commonly in the minor salivary glands of the head and neck. The most common sites of minor salivary-gland adenoid cystic carcinoma are the soft palate, oral cavity, and sinonasal tract.