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Adenoid Cystic Carcinomas account for __% of all salivary gland neoplasms



what locations are usually effected with Adenoid Cystic Carcinomas?

A) Parotid and submandibular gland are affected about equally

B) Intraorally, the palate is the most commonly affected site, with approximately half of the intraoral cases involving that location


what population groups are at the highest risk for Adenoid Cystic Carcinomas?

Slight female predilection

Age range has been reported from 15-88 years, with a mean of 55 years, and most tumors present in the fifth decade


clinical characteristics of adenoid cystic carcinomas:

1) Lesion initially presents as a slow-growing, non-ulcerated, infiltrative mass

2) Frequently associated with pain or tenderness

3) Ulceration may develop later in its course


Histological characteristics of Adenoid Cystic Carcinomas:

A) Hyperchromatic basaloid cells with minimal cytoplasm

B) Little pleomorphism or mitotic activity

C) Marked propensity for this lesion to exhibit perineural and intraneural invasion


what are the 3 possible "growth patterns" for Adenoid Cystic Carcinoma?

tubular - well-differentiated

cribriform - classic "Swiss cheese" pattern- intermediate dif

solid - poorly-differentiated


what is the treatment/prognosis for Adenoid Cystic Carcinoma?

Tx: Wide surgical excision, with radiation therapy afterwards

Prognosis: Generally poor - slow-growing and relentless, with death from disease up to 20-25 years after diagnosis


what does the prognosis for Adenoid Cystic Carcinoma depend on?

Depends on location of lesion, grade, anatomic structures involved, presence of tumor at surgical margins


Metastases from Adenoid cystic carcinomas typically go to what locations?

- go to the lung, followed by brain, bone and liver

- Lymph node involvement typically accounts for only 5% of metastatic deposits of adenoid cystic Ca


T/F: the 10 year survival of Adenoid cystic carcinoma is only 50%


10-year survival – 50%
20-year survival – 25%


what is the Incidence of Acinic Cell Adenocarcinoma? where do they usually occur?

This neoplasm comprises only 2% of all salivary gland tumors, with the vast majority occurring in the parotid (90%)

The remaining 10% usually seen intraorally


what population group is at the highest risk for developing Acinic Cell Adenocarcinoma?

What are the clinical characteristics?

A) Age range is reported from 5-84 years, with a mean age of about 45 years

B) Fairly circumscribed, slow-growing mass in the parotid region; intraorally – buccal mucosa or palate

C) Pain or tenderness may eventually become evident in nearly half the cases


Histological characteristic of Acinic Cell Adenocarcinoma:

Often appear to be pseudo-encapsulated

Basophilic, bland cells histologically very similar to acinar cells


Treatment/prognosis/metastasis of Acinic Cell Adenocarcinoma

Tx: Surgical excision

Prognosis: Guarded

In AFIP series, 35% recurred, 16% metastasized (usually to lymph node) and 16% died of their disease


Most cases of Carcinoma ex-Mixed Tumor (Ca ex-PA) occur in what age groups?

what is the primary clinical symptom?

Peak incidence in the sixth to eighth decades of life

Long-standing asymptomatic mass that suddenly becomes tender or is associated with paresthesia


what are the histological characteristic of Carcinoma ex-mixed tumors?

The majority of carcinomas ex-PA show areas of typical pleomorphic adenoma from which carcinomatous elements appear to arise


In cases of Carcinoma ex-mixed tumors, most malignancies that occur will be what form?

Malignancy is usually a form of adenocarcinoma (NOS), sometimes PLGA, adenoid cystic Ca or others


Treatments/prognosis/reoccurance of Carcinoma ex-PA tumors:

1) Tx: Wide surgical excision

2) Prognosis: Varies with degree of invasion and type of adenocarcinoma

3) Invasion:
8 mm - bad prognosis - all patients died


what are the 10 and 20 year survival rates for Adenoid cystic carcinoma?

10-year survival – 50%

20-year survival – 25%


T/F: Acinic cell adenocarcinomas are more common than Adenoid cystic carcinomas


Adenoid make up 5% of all Saliva Neoplasms
Acidic make up only 2%


which salivary gland carcinoma is found almost exclusively in the parotid? which is found in equal proportions in the parotid and submandibular?

Adenoid cystic carcinomas = equal Parotid and submandibular

Acinic cell adenocarcinomas = 90% in parotid