Adenoid Cystic Carcinoma Of Palate Research Articles

Prognostic factors of palatal adenoid cystic carcinoma: A single-center analysis of 85 cases.

The purpose of this retrospective study was to describe the clinicopathological characteristics of primary adenoid cystic carcinoma (ACC) of the palate and to identify the factors affecting prognosis. The medical records of 85 patients with primary ACC of the palate treated with surgery, with or without adjuvant radiotherapy/chemotherapy, from 2009 to 2019 were reviewed. The relationship of different clinical parameters with locoregional recurrence (LR), distant metastasis (DM), and overall survival (OS) were analyzed. Median follow-up time was 44.6 months. LR and DM rates were 24.7% and 25.9%, respectively, and the 5-year OS and disease-free survival (DFS) rates were 85.9% and 55.1%, respectively. Multivariate analysis showed that positive margins were independently associated with the risk of LR (p < .001). Positive margins (p = .001) and high histological grade (p = .031) were significantly associated with shorter OS. Positive surgical margins are a strong adverse prognostic factor affecting LR and OS in patients with ACC; apart from that, high histopathological grade is an independent predictor of poor OS. Level 3 (Prognosis - Cohort study).

Case report on adenoid cystic carcinoma of palate with review of literature

Adenoid cystic carcinoma (ACC) is a malignant tumor of minor salivary glands of the oral cavity, particularly the palate which accounts for about 5–10%. These tumors are slow growing with a high incidence of local recurrence, perineural invasion, and distant metastasis. Here, we report the case of a 69-year-old female who presented with swelling over the hard palate. Computerized tomography shows enhancing lesion along the undersurface of the left side of the hard palate, abutting the maxillary alveolus in the region of the second premolar and first two molars. There was no erosion of the inner cortex of the maxillary alveolus and no extension into the nasal cavity. Following the biopsy, she underwent a left hard palatectomy with upper alveolar resection. The final histopathological report confirmed ACC with no perineural invasion. Following she received adjuvant radiotherapy using an intensity-modulated radiotherapy technique. Now at 6 months of follow-up, there was no evidence of recurrence. Thus, our patient requires long-term follow-up to assess the benefit and survival outcome.

Unusual case of skull base adenoid cystic carcinoma presenting as skull base osteomyelitis: case report

BackgroundAdenoid cystic carcinoma is a rare malignancy. Tumours of palatal region with minor salivary gland origin do not generally present at an early stage as the tumour is submucosal with symptoms prevalent only when there is evidence of perineural spread of the tumour. We report a case of adenoid cystic carcinoma of the palate with rare presentation of left ear discharge and diplopia on left lateral gaze. We discuss the case with emphasis on imaging evaluation mimicking a case of infective etiology with adjacent skull base osteomyelitis on initial presentation. However, on follow-up and further evaluation the patient was diagnosed as adenoid cystic carcinoma of hard palate on left side.Case presentationA 25-year-old male patient has presented to Jagadguru Sri Shivarathreeswara Hospital in August 2019 with complaints of left ear discharge and diplopia on left lateral gaze since 1 week. The clinical and imaging findings was suggestive of infective etiology and the patient was treated for the same with IV antibiotics. Repeat magnetic resonance imaging was then done which revealed definitive reduction in the severity of inflammation suggestive of response to therapy. Patient was then discharged and was followed up. Three months later, the patient came with complaints of mass in left nasal cavity. Patient was then referred for contrast enhanced computed tomography neck strongly suggestive of neoplastic etiology. The patient was then operated and histopathological examination of the biopsy revealed adenoid cystic carcinoma.ConclusionsTumours of palatal region with minor salivary gland origin do not generally present at an early stage as the tumour is submucosal with symptoms prevalent only when there is evidence of perineural spread of the tumour. In our case patient presented with lateral rectus palsy, involvement of meckel’s cave, trigeminal nerve involvement and cavernous sinus involvement which are strong indicators of the perineural and locoregional spread of the tumour. Hence, it is important for the radiologist and clinician to strongly suspect and evaluate for a primary lesion of the head and neck when such a radiological presentation has been demonstrated.

Adenoid Cystic Carcinoma of Palate

Adenoid cystic carcinoma (ADCC) is one of the malignant salivary gland neoplasm and constitutes for 1% of head and neck malignancies and 22% of all salivary gland malignancies. Palate is the most common site to be involved in the oral cavity followed by parotid region, tongue, and floor of mouth. It is commonly seen in middle age population with slight female predilection. It usually appears as asymptomatic, slow growing infiltrative growth with high recurrence, often presence of perineural invasion which appears as pain. In this present case of ADCC, a 65-year-old female patient reported with a swelling on the left side of hard palatal area since 3 months with occasional pain and history of epistaxis, which was diagnosed clinically, radiographically, and histopathologically and confirmed by immunohistochemistry as Grade III solid variety of ADCC with a poor prognosis.

Delayed diagnosis of palatal adenoid cystic carcinoma: Review of diagnostic workup and image features of perineural spread

ObjectivesAdenoid cystic carcinoma (ACC) is the malignancy most likely to spread perineurally. Delayed diagnosis often leads to undetected perineural spread (PNS). Better understanding of diagnostic processes, clinical and imaging features in ACC may allow earlier diagnoses. Materials and methodsA retrospective records search of the University of Washington Radiology archive identified patients with palatal ACC diagnosis and pre-treatment MDCT and/or MRI. Demographic data, clinical findings, diagnostic workup history and image features including the presence of PNS were recorded. Results44 patients met inclusion and exclusion criteria. Symptoms included pain, mass, numbness, and sinonasal congestion. The most common finding on clinical examination was visible or palpable palatal mass. 55% of patients were evaluated by a dentist pre-diagnosis. Most common initial impressions were infection and/or dental disease. PNS was identified in 81.8% of patients, most commonly at pterygopalatine fossa, palatine foramina/canals, Vidian canal, or foramen rotundum. PNS was statistically significantly associated with paresthesia (p = 0.003) but not with tumor size, age, gender, or tobacco history. 44% of patients were diagnosed ≥1 year from initial symptoms, with a mean delay of 18.3 (range < 1–72) months. ConclusionsThis study represents the first analysis of the nature of the diagnostic process of palatal ACC. Majorities of patients were evaluated by a general dentist pre-diagnosis. PNS was identified in a majority of patients and all the patients who presented with paresthesia had evidence of PNS. Despite patients presenting with paresthesia, palatal ACC is often initially misdiagnosed resulting in delayed diagnosis.

Adenoid cystic carcinoma of palate: A rare case report

A 40-year-old female patient reported to the department with the complaint of a single growth and pain in the upper right back tooth region for 1 year. Intraoral examination revealed a single unilateral exophytic growth seen on the right upper pterygomandibular raphe region. Extraoral examination revealed no facial asymmetry and no evidence of lymphadenopathy. Histopathological examination revealed a hyperparakeratotic stratified squamous epithelium of variable thickness with broad and flattened rete ridges. Lesional tissue showed large sheets of cells surrounded by condensed collagen component. The lesional cells were basaloid in appearance with hyperchromatic nucleus predominately arranged in a cribriform pattern along with eosinophilic material. No evidence of perineural invasion was observed in serial sections. On the basis of these findings, the diagnosis of adenoid cystic carcinoma was established.

A case of palatal adenoid cystic carcinoma with late recurrence.

Adenoid cystic carcinoma (ACC) is a slow-growing, indolent cancer which normally develops in the head and neck salivary glands, but occasionally in the uterus.1 It can present with swelling, pain, and paraesthesia, as well as other symptoms such as epistaxis, nasal obstruction, depending on the location of the tumour.2 It accounts for 1% of the malignant tumours of the head and neck region.3 Classical management involves surgery and subsequent radiotherapy.4 The researchers describe a case of ACC of the minor salivary glands of the palate and nasopharynx that recurred 8 years following completion of treatment. A 57-year-old female presented to her GP with a 3-month history of left-sided catarrh and epistaxis from her left nostril. Clinical examination was unremarkable and the patient was initially diagnosed with sinusitis. However, the symptoms did not resolve following treatment for sinusitis. On further examination, her dentist noted left palatal swelling and referred her to the maxillofacial clinic by which time she had been suffering from these symptoms for 18 months. In hindsight, her epistaxis might have been a warning sign, and on reflection, the GP highlighted the need to take new epistaxis seriously. Clinical examination by the maxillofacial team revealed diffuse palatal swelling of the hard palate. Subsequent magnetic resonance imaging (MRI) showed a palatal tumour extending into the floor of the left nasal cavity and projecting into the left maxillary antrum through the medial wall. Biopsy of the palate showed an invasive tumour indicative of an ACC of minor salivary glands in the palate. Staging was T4N0M0. She underwent a …

Tubular adenoid cystic carcinoma of palate: A rare case report

Adenoid cystic carcinoma (ACC) is a rare malignant tumor that affects the major and minor salivary glands, the lacrimal glands, the ceruminous glands and occasionally the excretory glands of the female genital tract. 30-40% of these carcinomas occur in the head and neck region. Approximately 50-70% of the cases have been reported in the minor salivary glands. The most common location is the palate, generally in the area of the greater palatine foramen. ACC is generally characterized by a slow growth rate, and it is often present for several years before the patient seeks treatment. Here we present a case of 42-year-old female who came to the department for the complaint of a swelling over the right side of palate since 2-3 months which was diagnosed as a benign tumor initially, but was confirmed as tubular ACC histologically.

Adenoid cystic carcinoma of palate

Adenoid cystic carcinoma is a rare tumor arising from the minor salivary glands;, the palate being the commonest site. Distant metastasis and perineural invasion areis common in adenoid cystic carcinoma. Diagnosis of adenoid cystic carcinoma is made usually with the help of clinical features, radiographic features and histologic features. We reported a case of adenoid cystic carcinoma of palate involving left maxillary sinus. The diagnosis of the case and brief review of literature of adenoid cystic carcinoma is discussed. The aim here is to highlight the importance of diagnosis, treatment and long-term follow-up of the patients with adenoid cystic carcinoma.

Adenoid cystic carcinoma of palate: A case report and review of literature

Adenoid cystic carcinoma is an uncommon, slow growing malignant salivary gland tumor that is characterized by wide local infiltration, perineural spread, propensity to local recurrence and distant metastasis. In this paper, the authors present a case of adenoid cystic carcinoma affecting the palate and involving the maxillary sinus in a 60-year-old male patient along with a brief review of literature.

Salivary tumors in north Jordanians: A descriptive study

To evaluate the types and distribution of tumors of salivary glands in north Jordanians. The records of the Department of Pathology at Jordan University of Science and Technology were reviewed for patients who were treated for salivary gland tumors from 1991 to 2002. The tumors were analyzed for age of patient, sex of patient, tumor site, and tumor type. One hundred two true neoplasms (70% benign and 30% malignant) were found. The most frequent benign and malignant neoplasms found were pleomorphic adenoma (54%) and adenoid cystic carcinoma (13%), respectively. The most common major and minor salivary gland sites were the parotid (51%) and palatal glands (20%), respectively. Although most of major gland tumors were adenomas, carcinomas of the minor glands were only slightly less frequent than adenomas. The most frequent malignant parotid tumors were adenoid cystic carcinoma and mucoepidermoid carcinoma. The most frequent minor salivary gland malignant tumors were palatal adenoid cystic carcinoma. Age ranged from 1 to 94 (mean 40) years, with a male to female ratio of 1:1.2. North Jordanians with salivary gland tumors were found to have similar characteristics with patients of other countries with regard to tumor type, tumor site distribution, and age and sex of patients.

Palatal Adenoid Cystic Carcinoma Presenting as Perineural Spread to the Cavernous Sinus

Adenoid cystic carcinoma of the hard or soft palate is a slow-growing, insidious disease with a tendency to spread via a perineural mechanism along the palatine branches of the maxillary division of the trigeminal nerve. Such spread may present first as a tumor in the pterygopalatine fossa or cavernous sinus. The purpose of this manuscript is to report three cases of palatal adenoid cystic carcinoma which presented as a mass in the cavernous sinus prior to discovery of the palate primary tumor. The imaging features of these cases are emphasized as is the need to search for a head and neck primary lesion when faced with a cavernous sinus mass.

P53 Oncoprotein accumulation in adenoid cystic carcinoma of parotid and palatine salivary glands

Previous studies have suggested that alterations of the p53 gene are the most common genetic abnormality in human cancer. The aims of the present study were to evaluate p53 protein (p53P) immunostaining in adenoid cystic carcinoma (ACC) of the salivary gland and to correlate the expression with patient survival. A total of 27 cases of ACC in the parotid gland (n = 12) and the minor palatine glands (n = 15) were studied, with ten cases each of normal parotid and palatine glands as non-neoplastic controls. Staining was performed with mouse monoclonal antibody DO-7 against p53 (Dako, USA) using the ABC method. Stained nuclei irrespective of intensity or frequency were considered as positive. The frequency of positive nuclei was evaluated as the p53P index (p53PI), the percentage of the total nuclei in the reference epithelium. Clinical survival data were available for patients for periods up to 156 months. Our data showed that no normal tissues showed immunoreactivity with p53P in their nuclei. Thirteen of 15 (87%) cases of palatal and two of 12 (17%) cases of parotid neoplasms stained with p53P and the p53PI ranged from 0.01 to 10%. The number of p53P positive tumors was significantly higher in palatal than in parotid neoplasms, suggesting that palatal ACCs may be more aggressive in comparison with parotid ACCs. Our data also showed that the number of p53P positive tumors was significantly increased in patients who died of tumors than in patients with no evidence of disease at the end of the follow-up period between 60 to 156 months. These results suggest that p53P may be involved in the development of salivary gland ACCs and that p53P analysis may be a useful indicator of poor prognosis.