Department of Surgery, Division of Otolaryngology, Head and Neck Surgery, University of Wisconsin-Madison School of Medicine and Public Health, USAFulltext PDF
Adenoid Cystic Carcinoma (ACC) is a rare cancer that arises from the salivary glands and other sites in the body, such as the lung and breast. Although the tumor accounts for 10% of all salivary gland malignancies, it only accounts for 1% of head and neck malignancies. It can affect both major and minor salivary glands - here it is called salivary gland adenoid cystic carcinoma or SACC - with a slight predilection to the latter, and commonly manifests between the 6th and 7th decades of life. The disease also shows a slight female predilection, with a reported female to male ratio of 3:2. Lesions of SACC are often insidious and slow-growing, and symptoms like pain and altered sensation are frequently associated with advanced stages of the disease. Salivary adenoid cystic carcinoma is characterized by Perineural Invasion (PNI), a distinctive feature that potentially plays a significant role in the tumor’s relapse and recurrence, which is approximately 50%. The disease is not prevalent, and its etiopathogenesis is poorly understood, although several genetic patterns and biomarkers have been linked to its initiation and/or progression. The discovery of these mutations and biomarkers has encouraged several clinical studies to use therapeutic agents to target the specific receptors on the cancer cells to potentially prevent further proliferation of the tumor cells and metastasis of the disease. Diagnosis of SACC is often challenging, and frequently requires a combination of clinical examination, imaging, and histopathology. Management of SACC is primarily surgical excision, while radiotherapy has shown to be effective in improving local control in cases with microscopic residual disease. However, treatment of recurrent or metastatic tumors by radiotherapy with or without chemotherapy has so far shown limited success.
Adenoid cystic carcinoma; Tumor; Salivary gland; Epidemiology; Metastasis; Histopathology; Etiology
Eyad Saleh, Department of Surgery, Division of Otolaryngology, Head and Neck Surgery, University of Wisconsin- Madison School of Medicine and Public Health, USA, Tel: 07533686726; E-mail: [email protected].