Clinicopathological correlation of adenoid cystic carcinoma: A notorious masquerader and clinical paradox

Background: Adenoid cystic carcinoma (ACC) is an uncommon tumor with nonspecific clinicoradiological features thereby masquerading other nonneoplastic and neoplastic entities. Materials and Methods: Cases of ACC were retrospectively reviewed over a period of 4 years. The clinical details of these pa...

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Main Authors: Preeti Sharma, Vidya Jha, Ashish Kumar Mandal
Format: Article
Language:English
Published: Thieme Medical and Scientific Publishers Pvt. Ltd. 2018-01-01
Series:Indian Journal of Medical and Paediatric Oncology
Subjects:
Online Access:http://www.ijmpo.org/article.asp?issn=0971-5851;year=2018;volume=39;issue=3;spage=276;epage=281;aulast=Sharma
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author Preeti Sharma
Vidya Jha
Ashish Kumar Mandal
author_facet Preeti Sharma
Vidya Jha
Ashish Kumar Mandal
author_sort Preeti Sharma
collection DOAJ
description Background: Adenoid cystic carcinoma (ACC) is an uncommon tumor with nonspecific clinicoradiological features thereby masquerading other nonneoplastic and neoplastic entities. Materials and Methods: Cases of ACC were retrospectively reviewed over a period of 4 years. The clinical details of these patients including fine-needle aspiration cytology (FNAC) and imaging findings were retrieved. Diagnosis was confirmed on histomorphology and supplemented with immunohistochemistry (IHC). Results: Thirty cases of ACC were included in the study. Mean patient age was 55.5 years with a slight female preponderance. Among the 30 ACCs, 10 (33.4%) were located in submandibular gland, 7 (23.4%) in parotid gland, 6 (20%) in sublingual gland, 2 (6.7%) in lung and one each (3.33%) in nasal cavity, breast, cervix, lip, and skin of face. Preoperative imaging was suggestive of malignancy in 29 cases while a single case of parotid gland ACC was misdiagnosed as benign salivary gland neoplasm. FNAC was performed in 29 cases with a diagnostic accuracy of 82.7%. Histopathological examination showed characteristic features of ACC in all cases with perineural invasion seen in 7 cases. On IHC, positivity for cytokeratin was seen in all cases, cluster of differentiation 117 in 24 cases, thyroid transcription factor-1 in two cases and human epidermal growth factor receptor/neu in two cases. All cases were negative for estrogen receptor and progesterone receptor IHC. Mean Ki-67 score was 47.8%. Conclusion: ACCs are notorious tumors showing slow growth kinetics with propensity for perineural invasion, late recurrences, and distant metastasis. It should be kept in mind as a differential diagnosis at unusual sites other than salivary glands.
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spelling doaj-art-48b7c0098abc40f6bcaae6be2f5a664f2025-08-20T02:13:27ZengThieme Medical and Scientific Publishers Pvt. Ltd.Indian Journal of Medical and Paediatric Oncology0971-58512018-01-0139327628110.4103/ijmpo.ijmpo_141_16Clinicopathological correlation of adenoid cystic carcinoma: A notorious masquerader and clinical paradoxPreeti SharmaVidya JhaAshish Kumar MandalBackground: Adenoid cystic carcinoma (ACC) is an uncommon tumor with nonspecific clinicoradiological features thereby masquerading other nonneoplastic and neoplastic entities. Materials and Methods: Cases of ACC were retrospectively reviewed over a period of 4 years. The clinical details of these patients including fine-needle aspiration cytology (FNAC) and imaging findings were retrieved. Diagnosis was confirmed on histomorphology and supplemented with immunohistochemistry (IHC). Results: Thirty cases of ACC were included in the study. Mean patient age was 55.5 years with a slight female preponderance. Among the 30 ACCs, 10 (33.4%) were located in submandibular gland, 7 (23.4%) in parotid gland, 6 (20%) in sublingual gland, 2 (6.7%) in lung and one each (3.33%) in nasal cavity, breast, cervix, lip, and skin of face. Preoperative imaging was suggestive of malignancy in 29 cases while a single case of parotid gland ACC was misdiagnosed as benign salivary gland neoplasm. FNAC was performed in 29 cases with a diagnostic accuracy of 82.7%. Histopathological examination showed characteristic features of ACC in all cases with perineural invasion seen in 7 cases. On IHC, positivity for cytokeratin was seen in all cases, cluster of differentiation 117 in 24 cases, thyroid transcription factor-1 in two cases and human epidermal growth factor receptor/neu in two cases. All cases were negative for estrogen receptor and progesterone receptor IHC. Mean Ki-67 score was 47.8%. Conclusion: ACCs are notorious tumors showing slow growth kinetics with propensity for perineural invasion, late recurrences, and distant metastasis. It should be kept in mind as a differential diagnosis at unusual sites other than salivary glands.http://www.ijmpo.org/article.asp?issn=0971-5851;year=2018;volume=39;issue=3;spage=276;epage=281;aulast=SharmaAdenoid cystic carcinomafine-needle aspiration cytologyperineuralsalivary glands
spellingShingle Preeti Sharma
Vidya Jha
Ashish Kumar Mandal
Clinicopathological correlation of adenoid cystic carcinoma: A notorious masquerader and clinical paradox
Indian Journal of Medical and Paediatric Oncology
Adenoid cystic carcinoma
fine-needle aspiration cytology
perineural
salivary glands
title Clinicopathological correlation of adenoid cystic carcinoma: A notorious masquerader and clinical paradox
title_full Clinicopathological correlation of adenoid cystic carcinoma: A notorious masquerader and clinical paradox
title_fullStr Clinicopathological correlation of adenoid cystic carcinoma: A notorious masquerader and clinical paradox
title_full_unstemmed Clinicopathological correlation of adenoid cystic carcinoma: A notorious masquerader and clinical paradox
title_short Clinicopathological correlation of adenoid cystic carcinoma: A notorious masquerader and clinical paradox
title_sort clinicopathological correlation of adenoid cystic carcinoma a notorious masquerader and clinical paradox
topic Adenoid cystic carcinoma
fine-needle aspiration cytology
perineural
salivary glands
url http://www.ijmpo.org/article.asp?issn=0971-5851;year=2018;volume=39;issue=3;spage=276;epage=281;aulast=Sharma
work_keys_str_mv AT preetisharma clinicopathologicalcorrelationofadenoidcysticcarcinomaanotoriousmasqueraderandclinicalparadox
AT vidyajha clinicopathologicalcorrelationofadenoidcysticcarcinomaanotoriousmasqueraderandclinicalparadox
AT ashishkumarmandal clinicopathologicalcorrelationofadenoidcysticcarcinomaanotoriousmasqueraderandclinicalparadox