title: Cervical Lymph Node Metastasis in High-Grade Transformation of Head and Neck Adenoid Cystic Carcinoma: A Collective International Review.
abstract: Adenoid cystic carcinoma (AdCC) is among the most common malignant tumors of the salivary glands. It is characterized by a prolonged clinical course, with frequent local recurrences, late onset of metastases and fatal outcome. High-grade transformation (HGT) is an uncommon phenomenon among salivary carcinomas and is associated with increased tumor aggressiveness. In AdCC with high-grade transformation (AdCC-HGT), the clinical course deviates from the natural history of AdCC. It tends to be accelerated, with a high propensity for lymph node metastasis. In order to shed light on this rare event and, in particular, on treatment implications, we undertook this review: searching for all published cases of AdCC-HGT. We conclude that it is mandatory to perform elective neck dissection in patients with AdCC-HGT, due to the high risk of lymph node metastases associated with transformation.
authors.affiliation: Department of Biomedical Sciences and Medicine, University of Algarve, Faro, Portugal.
authors.forename: Henrik
authors.initials: H
authors.lastname: Hellquist
authors.affiliation: Department of Pathology, Faculty of Medicine in Plzen, Charles University in Prague, Plzen, Czech Republic.
authors.forename: Alena
authors.initials: A
authors.lastname: Skálová
authors.affiliation: Department of Pathology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
authors.forename: Leon
authors.initials: L
authors.lastname: Barnes
authors.affiliation: Department of Anatomic Pathology, Hospital Clinic, University of Barcelona, Barcelona, Spain.
authors.forename: Antonio
authors.initials: A
authors.lastname: Cardesa
authors.affiliation: Southern California Permanente Medical Group, Woodland Hills, CA, USA.
authors.forename: Lester D R
authors.initials: LD
authors.lastname: Thompson
authors.affiliation: Oral and Maxillofacial Pathology, School of Dentistry, University of Liverpool and Cellular Pathology, Liverpool Clinical Laboratories, Liverpool, UK.
authors.forename: Asterios
authors.initials: A
authors.lastname: Triantafyllou
authors.affiliation: Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
authors.forename: Michelle D
authors.initials: MD
authors.lastname: Williams
authors.affiliation: Department of Pathology, Allegiance Health, Jackson, MI, USA.
authors.forename: Kenneth O
authors.initials: KO
authors.lastname: Devaney
authors.affiliation: University Pathologists, Providence, RI, USA.|University Pathologists, Fall River, MA, USA.
authors.forename: Douglas R
authors.initials: DR
authors.lastname: Gnepp
authors.affiliation: Departments of Pathology and Otolaryngology-Head and Neck Surgery, The Johns Hopkins Medical Institutions, Baltimore, MD, USA.
authors.forename: Justin A
authors.initials: JA
authors.lastname: Bishop
authors.affiliation: Department of Pathology, Beth Israel Medical Center, New York, NY, USA.
authors.forename: Bruce M
authors.initials: BM
authors.lastname: Wenig
authors.affiliation: Fundación de Investigación e Innovación Biosanitaria del Principado de Asturias, Oviedo, Spain.|Instituto Universitario de Oncología del Principado de Asturias, University of Oviedo, Oviedo, Spain.
authors.forename: Carlos
authors.initials: C
authors.lastname: Suárez
authors.affiliation: Department of Otolaryngology, Hospital Universitario Central de Asturias, Oviedo, Spain.|Instituto Universitario de Oncología del Principado de Asturias, University of Oviedo, Oviedo, Spain.
authors.forename: Juan P
authors.initials: JP
authors.lastname: Rodrigo
authors.affiliation: Department of Otolaryngology, Hospital Universitario Central de Asturias, Oviedo, Spain.
authors.forename: Andrés
authors.initials: A
authors.lastname: Coca-Pelaz
authors.affiliation: Department of Radiation Oncology, Institute of Oncology, Ljubljana, Slovenia.
authors.forename: Primož
authors.initials: P
authors.lastname: Strojan
authors.affiliation: Head and Neck Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
authors.forename: Jatin P
authors.initials: JP
authors.lastname: Shah
authors.affiliation: Department of Head and Neck Surgery, Head and Neck Oncology Program, St Luc University Hospital and King Albert II Cancer Institute, Brussels, Belgium.
authors.forename: Marc
authors.initials: M
authors.lastname: Hamoir
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Nottingham University Hospitals, Queens Medical Centre Campus, Nottingham, UK.|European Salivary Gland Society, Geneva, Switzerland.
authors.forename: Patrick J
authors.initials: PJ
authors.lastname: Bradley
authors.affiliation: Departments of Surgery and Otolaryngology-Head and Neck Surgery, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, NY, USA.
authors.forename: Carl E
authors.initials: CE
authors.lastname: Silver
authors.affiliation: Department of Pathology, Radboud University Medical Center, Nijmegen, The Netherlands.
authors.forename: Pieter J
authors.initials: PJ
authors.lastname: Slootweg
authors.affiliation: European Salivary Gland Society, Geneva, Switzerland.|Otorhinolaryngology-Head and Neck Surgery and Department of Oncology, Section Head and Neck Oncology, University Hospitals Leuven, KU Leuven, Leuven, Belgium.
authors.forename: Vincent
authors.initials: V
authors.lastname: Vander Poorten
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Philipp University, Marburg, Germany.
authors.forename: Afshin
authors.initials: A
authors.lastname: Teymoortash
authors.affiliation: Department of Otorhinolaryngology, The University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA.
authors.forename: Jesus E
authors.initials: JE
authors.lastname: Medina
authors.affiliation: Division of Otolaryngology-Head and Neck Surgery, Southern Illinois University School of Medicine, Springfield, IL, USA.
authors.forename: K Thomas
authors.initials: KT
authors.lastname: Robbins
authors.affiliation: Department of Surgery, Banner MD Anderson Cancer Center, Gilbert, AZ, USA.
authors.forename: Karen T
authors.initials: KT
authors.lastname: Pitman
authors.affiliation: Department of Head and Neck Surgery and Otorhinolaryngology, A. C. Camargo Cancer Center, São Paulo, Brazil.
authors.forename: Luiz P
authors.initials: LP
authors.lastname: Kowalski
authors.affiliation: Department of Head and Neck Surgical Oncology, UMC Utrecht Cancer Center, University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: Remco
authors.initials: R
authors.lastname: de Bree
authors.affiliation: Department of Radiation Oncology, University of Florida, Gainesville, FL, USA.
authors.forename: William M
authors.initials: WM
authors.lastname: Mendenhall
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Neurological Institute of New Jersey, Rutgers New Jersey Medical School, Newark, NJ, USA.
authors.forename: Jean Anderson
authors.initials: JA
authors.lastname: Eloy
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Radboud University Medical Center, Nijmegen, The Netherlands.
authors.forename: Robert P
authors.initials: RP
authors.lastname: Takes
authors.affiliation: University of Udine School of Medicine, Udine, Italy.
authors.forename: Alessandra
authors.initials: A
authors.lastname: Rinaldo
authors.affiliation: Coordinator of the International Head and Neck Scientific Group, Padua, Italy. a.ferlito@uniud.it.
authors.forename: Alfio
authors.initials: A
authors.lastname: Ferlito
mesh_terms: D000328:Adult; D003528:Carcinoma, Adenoid Cystic / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D005260:Female; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology; D008207:Lymphatic Metastasis / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D012468:Salivary Gland Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery
keywords: Adenoid cystic carcinoma; Dedifferentiation; Fatal outcome; High-grade transformation; Local recurrence; Lymphatic metastasis; Neck dissection; Neoplasm recurrence; Salivary glands