title: Bilateral intraosseous adenoid cystic carcinoma of the mandible: report of a case with lung metastases at first clinical presentation.
abstract: OBJECTIVE
  Malignant epithelial tumours arising in the jaws are very rare. Adenoid cystic carcinoma (ACC) represents approximately 7.5% of all carcinomas and only a few cases of intraosseous (central) ACC have been reported in the literature.
  
  
  METHODS
  The salient clinico-pathological features of a case of ACC, bilaterally occurring in the mandible of a young caucasian woman who also had lung metastases are reported to appropriately characterize such unusual lesions and discriminate them from other tumours that more commonly affect the mandible.
  
  
  RESULTS
  The patient presented with a painful swelling of the right retro-molar area and paraesthesia of the ipsilateral lower lip and radiological investigations disclosed bilateral radiolucent lesions of the mandible with unequivocal signs of malignancy but without intra-lesional calcifications or association with teeth roots or cystic component. Conventional histological examination disclosed typical ACC with solid and cribriform growth patterns and extensive infiltration of the adjacent tissues.
  
  
  CONCLUSIONS
  The diagnosis of intraosseous malignant salivary gland type neoplasms is very difficult in view of their rarity and lack of specific signs and mainly achieved after histological examination and complete clinico-radiological work up. As surgical treatment of the patient was not indicated, due to extensive neoplastic disease, the patient is being controlled with multimodal treatment, including chemo- and radiotherapy and is alive with persistent disease 3 years after the original diagnosis.
authors.affiliation: Department of Dental Sciences and Surgery, University of Bari - piazza Giulio Cesare, 11, 70124 Bari, Italy. saveriocapodiferro@liberto.it
authors.forename: S
authors.initials: S
authors.lastname: Capodiferro
authors.forename: C
authors.initials: C
authors.lastname: Scully
authors.forename: M G
authors.initials: MG
authors.lastname: Macaita
authors.forename: M G
authors.initials: MG
authors.lastname: Lacaita
authors.forename: L
authors.initials: L
authors.lastname: Lo Muzio
authors.forename: G
authors.initials: G
authors.lastname: Favia
authors.forename: G
authors.initials: G
authors.lastname: Favic
authors.forename: E
authors.initials: E
authors.lastname: Mairoano
mesh_terms: D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D003528:Carcinoma, Adenoid Cystic / Q000188:drug therapy / Q000473:pathology* / Q000532:radiotherapy / Q000556:secondary*; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy / Q000532:radiotherapy / Q000556:secondary*; D008339:Mandibular Neoplasms / Q000188:drug therapy / Q000473:pathology* / Q000532:radiotherapy; D009361:Neoplasm Invasiveness; D012468:Salivary Gland Neoplasms / Q000188:drug therapy / Q000473:pathology* / Q000532:radiotherapy; D012470:Salivary Glands, Minor / Q000473:pathology*