ADENOID CYSTIC CARCINOMA- Overview, Facts, Types and Symptoms

ADENOID CYSTIC CARCINOMA

Adenoid Cystic Carcinoma is an uncommon malignant growth found in the salivary glands. This type of malignancy can be seen on other parts of the body such as the trachea (otherwise known as the windpipe or the tube where the air passes through from your nose to your lungs), breast, lacrimal glands (responsible for the secretion and storage of tears) and the paranasal sinuses among others. Though this carcinoma is considered malignant, it has a shallow potential for mortality.

TYPES

Three major types of Adenoid cystic carcinoma are identified through histopathologic examination, and these include: 

  • Cribriform
  • Tubular 
  • Solid- Has the most aggressive course

SYMPTOMS

The oral cavity has numerous salivary glands, and the presenting symptom of ACC is dependent upon the location of the tumor. The symptoms can vary from a painless nodule to a more painful one, mainly associated with swallowing the food, thereby causing the patient to lose weight because of their fear of pain upon deglutition. Listed below are the common symptoms in no particular order.

  • A mass that can be felt on either side of the jawline or in the preauricular area (a portion of the face located before the ear)
  • Mucosal discoloration anywhere in the oral cavity
  • Change in the timbre of the voice
  • Inability to swallow bolus of food (later stages) or pain on swallowing
  • Change in the sensation of the face (this is due to the impingement of the facial nerve). 

DIAGNOSIS

Due to the slow course of the disease, the person may disregard the presenting symptoms and may only be alarmed if the lump doesn’t go away after several weeks, causing a delay in the diagnosis. 

For the diagnosis to be made, your doctor may do either of the following procedures: 

  • Needle biopsy (a process wherein a needle is placed on the area of the tumor to extract a tissue sample and be sent for histopathologic examination). 
  • Surgical resection, wherein the entire tumor and the surrounding tissue is removed and examined under the microscope so that an appropriate staging or classification can be done. 
  • Imaging procedures that may include Computed Tomography Scan (CT Scan), Positron Emission Tomography Scan (PET scan), and Magnetic Resonance Imaging (MRI) to evaluate the extent of the tumor. CT Scans are usually requested if the patient has symptoms that point to impingement of the nearby structures such as the change in the timbre of voice and facial paralysis.

TREATMENT

Treatment options depend mainly on the staging and histologic classification. The gold standard for therapy is resection or removal of the mass itself and its surrounding unaffected tissue to minimize the recurrence of the malignancy. 

Radiotherapy uses high dose radiation to target ACC affected areas. This method of treatment is usually used as a follow-up therapy after the surgical resection, especially among cases where the metastasis or the spread of the malignancy has reached specific layers not visible to the naked eye. 

Chemotherapy utilizes certain drugs that target cancer cells. Still, this type of treatment is more systemic and thereby causes more unwanted side effects such as anorexia ( loss of appetite), disequilibrium, and sometimes damages the healthy cells too.

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