Antigoni Delantonia, Sarafopoulos Apostolosb, Zisis V.c, Anagnostou Eleftheriosc, Vachtsevanos Konstantinosd, Paraskevopoulos Konstantinosd, Andreadis Dimitriosc
aAristotle University of Thessaloniki, Department of Dentoalveolar Surgery, Implant Surgery and Radiology, Greece
bAhepa General Hospital, Department of Radiology, Greece
cAristotle University of Thessaloniki, Department of Oral Medicine and Pathology, Greece
dAristotle University of Thessaloniki, Department of Oral and Maxillofacial Surgery, Greece
Abstract
Background/Aim: Adenoid cystic carcinoma (ACC) is a rare type of cancer that most often occurs in the salivary glands. The aim of this report was to describe a very rare case of ACC in the floor of the mouth referring to the usefulness of combined imaging methodology for the detection of the exact origin and extension of the tumor. Case Report: A 70-year-old female patient was referred to the private practice of one of the authors (D.A., Thessaloniki, Greece). Before the examination, the patient provided written informed consent in accordance with the Helsinki Declaration for research and patient’s ethics. Subsequently, the patient was examined thoroughly. She exhibited a swelling on the floor of the mouth (left side). The swelling was painless, firm-solid upon palpation, non-movable and attached to adjacent tissues with normal covering oral mucosa. The patient was referred for an ultrasonography and MRI examination and afterwards an incisional biopsy was performed. The surgical removal of ACC and the involved sublingual but also the adjacent submandibular (for safety reasons) salivary glands were performed under general nasopharyngeal anesthesia with bilateral, both external and intraoral access. In addition, post-surgical radiotherapy was performed. Conclusions: Due to the aggressiveness of the lesion and the fact that in most cases adjacent tissues are affected, surgeons tend to be rather aggressive in their interventions. The imaging techniques may vary in their interpretation of the lesions. Ultrasonography and MRI examinations may assist the surgeon by depicting borders of the lesion under investigation, much more accurately, supporting the establishment of the diagnosis and avoiding the unnecessary loss of healthy neighboring tissue.
Keywords: ultrasonography; MRI; Adenoid Cystic Carcinoma
Reference
Amit, M., Na’ara, S., Sharma, K., Ramer, N., Ramer, I., Agbetoba, A., i dr. (2015) Elective neck dissection in patients with head and neck adenoid cystic carcinoma: An international collaborative study. Ann Surg Oncol, 22 (4): 1353-1359
Coca-Pelaz, A., Rodrigo, J.P., Bradley, P.J., Vander, P.V., Triantafyllou, A., Hunt, J.L., i dr. (2015) Adenoid cystic carcinoma of the head and neck -An update. Oral Oncol, 51(7): 652-61
Dubergé, T., Bénézery, K., Resbeut, M., Azria, D., Minsat, M., Ellis, S., i dr. (2012) Carcinomes adénoïdes kystiques ORL: étude rétrospective multicentrique de 169 cas. Cancer Radiother, 16(4): 247-256
Giannini, P.J., Shetty, K.V., Horan, S.L., Reid, W.D., Litchmore, L.L. (2006) Adenoid cystic carcinoma of the buccal vestibule: A case report and review of the literature. Oral Oncol, 42(10): 1029-1032
Hay, A.J., Migliacci, J., Karassawa, Z.D., McGill, M., Patel, S., Ganly, I. (2019) Minor salivary gland tumors of the head and neck-Memorial Sloan Kettering experience: Incidence and outcomes by site and histological type. Cancer, 125(19): 3354-3366
3
Jones, A.V., Craig, G.T., Speight, P.M., Franklin, C.D. (2008) The range and demographics of salivary gland tumours diagnosed in a UK population. Oral Oncol, 44(4): 407-17
Kopeć, T., Mikaszewski, B., Jackowska, J., Waśniewska-Okupniak, E., Szyfter, W., Wierzbicka, M. (2015) Treatment of parotid malignancies: 10 years of experience. J Oral Maxillofac Surg, 73(7): 1397-1402
Lee, R.H., Wai, K.C., Chan, J.W., Ha, P.K., Kang, H. (2022) Approaches to the Management of Metastatic Adenoid Cystic Carcinoma. Cancers (Basel), 14(22): 5698
Qin, W., Chong, R., Huang, X., Liu, M., Yin, Z.Q. (2012) Adenoid cystic carcinoma of the lacrimal gland: CT and MRI findings. Eur J Ophthalmol, 22(3): 316-319
Saleh, E., Ukwas, A. (2023) Adenoid Cystic Carcinoma of Salivary Glands: A Ten-Year Review and an Assessment of the Current Management, Surgery, Radiotherapy, and Chemotherapy. Int J Otolaryngol, 2023: 1-16, Gazia F. (ed.)
Slootweg, P.J., El-Naggar, A.K. (2018) World Health Organization 4th edition of head and neck tumor classification: Insight into the consequential modifications. Virchows Arch, 472(3): 311-313
Yacoub, J.H., Clark, J.A., Paal, E.E., Manning, M.A. (2021) Approach to cystic lesions in the abdomen and pelvis, with radiologic-pathologic correlation. Radiographics, 41(5): 1368-1386
1
Yousem, D.M., Kraut, M.A., Chalian, A.A. (2000) Major Salivary Gland Imaging. Radiology, 216(1): 19-29
Balkan Journal of Dental Medicine, 2024, vol. 28, br. 2, str. 143-149