Primary intraosseous ACC of mandible of possible salivary origin: A rare clinical entity.
BACKGROUND
Adenoid cystic carcinoma (ACC) is a malignant tumor mainly of salivary origin which is well known for its deceptively benign histologic appearance characterized by indolent, locally invasive growth with high propensity for local recurrence and distant metastasis.


METHODS
An unusual case of a 23-year-old woman was reported in our hospital. After investigations, it showed that it is a second primary intraosseous lesion of mandible that occurred subsequently after ACC of parotid gland. After diagnosis was established, resection of tumor and reconstruction with a free fibula flap was performed. Ten months follow-up showed no signs of recurrence or metastasis.


CONCLUSIONS
Among the salivary neoplasms, adenoid cystic carcinoma is very rare and intraosseous lesions are even rarer. We found a total of 26 cases of primary ACC of the mandible reported in the literature. Pain and swelling were the most frequent symptoms.


CONCLUSIONS
This case illustrates two key facts. First, not all cystic lesions are necessarily metastatic or recurrence. Second is, even though the exact origin of this tumor is unknown, central salivary gland tumors should be considered in the differential diagnosis of cystic lytic lesions in the mandible.
Department of Oral and Maxillofacial Surgery, The Second Xiangya Hospital of Central South University, Renmin Road, No. 139, Changsha, Hunan 410011, China.
Zhen H
ZH
Ren
Department of Oral and Maxillofacial Surgery, The Second Xiangya Hospital of Central South University, Renmin Road, No. 139, Changsha, Hunan 410011, China.
Daminee
D
Chickooree
Department of Oral and Maxillofacial Surgery, The Second Xiangya Hospital of Central South University, Renmin Road, No. 139, Changsha, Hunan 410011, China.
Jin B
JB
Liu
Department of Oral and Maxillofacial Surgery, The Second Xiangya Hospital of Central South University, Renmin Road, No. 139, Changsha, Hunan 410011, China. Electronic address: drwuhj@hotmail.com.
Han J
HJ
Wu
Fibula osteocutaneous flap; Intraosseous ACC; Mandible; Parotid gland