Clinical Case Detail

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

Diagnosis

Acinic Cell Adenocarcinoma

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