IADR Abstract Archives
Adenoid Cystic Carcinoma (ACC) of the Accessory Salivary Glands: About a Clinical Case
Objectives: Adenoid cystic carcinoma (ACC) is a malignant epithelial tumor, with double epithelial and basal / myoepithelial contingent. It’s relatively rare neoplastic disease, particularly manifesting in mucous glands. Compared with other epithelial tumors of the head and neck, ACC is known for its infiltrating nature. They can affect all the salivary glands but 50% to 60% are develop in the accessory salivary glands, the site of predilection is the palate. The objective of this work is to discuss, through a clinical case, the clinical, radiological and histological diagnosis as well as the management of an ACC.
Methods:
A 43-year-old patient consults at the oral medicine and surgery department of Monastir university hospital clinic for palatal swelling right evolving for 2 years. The exo-oral examination is unremarkable. The endo-oral examination shows Palatal swelling 3 cm in large diameter, firm, fixed to the deep and superficial planes and extends from 15 to 17. The vitality test is positive on the teeth related to this swelling. Standard X-ray (retro-alveolar + panoramic) doesn’t show pathological images. Computed tomography shows a large diameter 54mm hypodense image of the posterior part and right palate The treatment decision is a right hemi maxillectomy which was performed at the department of Maxillofacial surgery of Sousse. Result of the final histological examination Confirm the diagnosis of ACC of the accessory salivary glands of the the right half palate
Results: ACC is most often clinically misleading due to its small size and slow growth. Cystic adenoid carcinoma shows the presence of three architectural structures: The cribriform pattern is the most frequently observed, the tubular pattern, and the solid pattern which has been associated with the worst prognosis. This tumor may present several differential diagnoses, including low-grade polymorphic adenocarcinoma, pleomorphic adenoma, salivary ductal carcinoma, and muco-epidermal carcinoma.
Conclusions: The prognosis depends on several factors: the histological type of the tumor, the histological grade of malignancy, and the stage of progression at the time of diagnosis.
Methods:
A 43-year-old patient consults at the oral medicine and surgery department of Monastir university hospital clinic for palatal swelling right evolving for 2 years. The exo-oral examination is unremarkable. The endo-oral examination shows Palatal swelling 3 cm in large diameter, firm, fixed to the deep and superficial planes and extends from 15 to 17. The vitality test is positive on the teeth related to this swelling. Standard X-ray (retro-alveolar + panoramic) doesn’t show pathological images. Computed tomography shows a large diameter 54mm hypodense image of the posterior part and right palate The treatment decision is a right hemi maxillectomy which was performed at the department of Maxillofacial surgery of Sousse. Result of the final histological examination Confirm the diagnosis of ACC of the accessory salivary glands of the the right half palate
Results: ACC is most often clinically misleading due to its small size and slow growth. Cystic adenoid carcinoma shows the presence of three architectural structures: The cribriform pattern is the most frequently observed, the tubular pattern, and the solid pattern which has been associated with the worst prognosis. This tumor may present several differential diagnoses, including low-grade polymorphic adenocarcinoma, pleomorphic adenoma, salivary ductal carcinoma, and muco-epidermal carcinoma.
Conclusions: The prognosis depends on several factors: the histological type of the tumor, the histological grade of malignancy, and the stage of progression at the time of diagnosis.