CPC Case I
Provided By: Dr. Hope Wettan - 2011-05-18
Clinical History
34 year old male presents with 2.5 - 3 year history of growth on left posterior palate
 
S/P orthognathic surgery at 19 years old
 
GP performed curettage of palatal root of # 14 to treat presumed palatal abscess approximately 3 years ago
 
CBCT shows 2 cm X 1.5 cm lesion extending to floor of left maxillary sinus

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Diagnosis
Acinic Cell Adenocarcinoma

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Clinical Features
Malignant tumor of salivary glands with serous acinar differentiation
 
Formerly referred to as acinic cell tumor due to usual low-grade behavior
 
Comprise approx. 6%-10% of all salivary gland cancers
 
Approximately 85% occur in parotid, comprising ~1%-3% of all parotid tumors
 
~9% occur in minor salivary glands, with buccal mucosa, lips, palate being most common sites
 
Seen in broad age range, mean age 44
 
Female:Male = 3:2
 
Usually presents as slow growing mass, often present for many months or years before dx
 
Often asymptomatic; facial nerve paralysis is infrequent but ominous sign in parotid tumors
 
Several histologic patterns, including solid, microcystic, papillary-cystic and follicular
Treatment & Prognosis
Treatment:  wide local excision with partial or total removal of involved gland
 
Adjunctive RT for uncontrolled local disease
 
~1/3 of pts. have local recurrence
 
~10%-15% develop metastatic disease
 
Prognosis for minor gland tumors is better than that for tumors of major glands