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


METHODS
Retrospective study at Head and Neck Service, Universidade Estadual de Campinas.


METHODS
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.


RESULTS
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.


CONCLUSIONS
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.
Tincani
Alfio José
AJ
Department of Surgery, Faculdade de Ciências Médicas, Universidade Estadual de Campinas, Campinas, São Paulo, Brazil. alfio.jt@terra.com.br
Del Negro
André
A
Araújo
Priscila Pereira Costa
PP
Akashi
Hugo Kenzo
HK
Martins
Antonio Santos
AS
Altemani
Albina Milani
AM
Barreto
Gilson
G
D000328:Adult; D000368:Aged; D044963:Biopsy, Fine-Needle; D003528:Carcinoma, Adenoid Cystic / Q000473:pathology* / Q000601:surgery; D005260:Female; D006784:Hospitals, Teaching; D006801:Humans; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D012189:Retrospective Studies; D012468:Salivary Gland Neoplasms / Q000473:pathology* / Q000601:surgery