Adenoid cystic carcinoma of the minor salivary glands

Management of minor salivary gland adenoid cystic carcinoma is a controversial problem. Few clinicians obtain adequate experience in the treatment of this disease, which is often frustrated by early and late distant metastases. Fourteen cases of minor salivary gland adenoid cystic carcinoma recorded in the Delaware Registry over a 20-year period (1968 to 1988) were reviewed retrospectively. These cases were evaluated for their duration of symptoms; size, location, and histologic subtype of the lesion; perineural invasion; lymph node metastases; and treatment to determine the relationship of these factors to survival. Location and histologic subtype of the lesion and duration of symptoms were found to have a more significant impact on survival than size of the lesion, perineural invasion, or lymph node metastases. Surgery is the mainstay of therapy for minor salivary gland adenoid cystic carcinoma, with resection that includes disease-free margins but spares function being advocated. Although adjunctive radiation therapy has not been shown to increase survival, it is reasonable in lesions with perineural invasion and/or lymph node metastases.