[Lymph node metastasis of adenoid cystic carcinoma]

The adenocystic carcinoma (ACC) of the head and of the neck is rather uncommon. It is characterized by a very slow biological behaviour, which leads to locoregional recurrences and distant metastasis. Most reports concentrate on the unpredictable long-term behaviour of this tumor, whereas lymph nodes metastasis are not usually discussed in detail. The aim of this study was to evaluate the difficulties connected with the lymph node metastasis in ACC.

A group of 33 patients from 1980 to 1998, was observed. These patients have been subjected to surgical treatment in the Maxillo-Facial Surgery Department of the Policlinico-Umberto I of Rome.

Among 33 patients with ACC, 10 patients (30%) revealed, initially or during observation, cervical lymph node metastasis, which is a most common event in male subjects (70%). The lymph node involvement is much more common in carcinomas localized in the parotid and in the sublingual glands with a solid rather than a tubular histologic pattern. Direct correlation between age and metastasis lymph node involvement have not been documented.

Surgery for node disease has a very little impact on the locoregional and on the distant metastasis evolution of the tumor. Thus, our protocol of treatment of lymph nodes metastatic lesions follows the trend of most of the international authors, considering that the neck dissection should be performed only with a lymph adenopathy clinically evident or strongly suspected.