title: Cribriform adenocarcinoma of the tongue and minor salivary gland: transoral robotic surgical resection.
abstract: OBJECTIVE
  Cribriform adenocarcinoma of the tongue and minor salivary gland (CATMSG) is a rare, locally invasive, and poorly recognized tumor, typically occurring on the base of the tongue. This case report describes the previously unreported use of transoral robotic surgery (TORS) for the local resection of CATMSG in a novel location, the palatine tonsil, and leverages follow-up information to compare TORS to conventional surgical approaches.
  
  
  METHODS
  We performed transoral radical tonsillectomy, limited pharyngectomy, and base-of-tongue resection with staged left selective neck dissection.
  
  
  RESULTS
  Tumor pathology revealed an infiltrating salivary gland carcinoma with perineural invasion and a histologically similar adenocarcinoma in 1 of 64 left neck lymph nodes. TORS was performed with no perioperative complications, and the patient was subsequently discharge on postoperative day 3 with a Dobhoff tube. Postoperatively, the Dobhoff tube was removed at 1 month, the patient was advanced to soft foods by mouth at 2 months, and 3-month positron emission tomography-computed tomography scan showed no evidence of distant metastases and evolving postsurgical changes in the left tonsillectomy bed.
  
  
  CONCLUSIONS
  This case report highlights the use of TORS resection with minimal acute and long-term morbidity compared to conventional approaches for the resection of this rare, locally invasive salivary gland carcinoma in the palatine tonsil.
authors.affiliation: Department of Otorhinolaryngology - Head and Neck Surgery, University of Pennsylvania Medical Center, Philadelphia, Pa., USA.
authors.forename: Douglas M
authors.initials: DM
authors.lastname: Worrall
authors.forename: Jason A
authors.initials: JA
authors.lastname: Brant
authors.forename: Raymond L
authors.initials: RL
authors.lastname: Chai
authors.forename: Gregory S
authors.initials: GS
authors.lastname: Weinstein
mesh_terms: D000230:Adenocarcinoma / Q000601:surgery*; D002294:Carcinoma, Squamous Cell; D005260:Female; D006258:Head and Neck Neoplasms; D006801:Humans; D008875:Middle Aged; D037981:Neck Dissection; D010611:Pharyngectomy; D049268:Positron-Emission Tomography; D065287:Robotic Surgical Procedures / Q000379:methods*; D012468:Salivary Gland Neoplasms / Q000473:pathology / Q000601:surgery*; D012470:Salivary Glands, Minor / Q000473:pathology; D000077195:Squamous Cell Carcinoma of Head and Neck; D014057:Tomography, X-Ray Computed; D014059:Tongue / Q000473:pathology; D014062:Tongue Neoplasms / Q000473:pathology / Q000601:surgery*; D014068:Tonsillectomy