Malignant sublingual gland tumors: a retrospective clinicopathologic study of 28 cases

To evaluate the clinicopathologic features and therapeutic efficacy of malignant sublingual gland tumors.

From 1955 to 2005, the clinicopathologic data of 28 patients treated in our hospital were obtained from their medical records and histopathologic slides.

There were 16 males and 12 females, with a mean age of 50.3 years. Eighteen cases (64.3%) were adenoid cystic carcinoma; 16 (57.1%) cases were clinically staged as III-IV. Adenoid cystic carcinoma was mainly of the histologic type, and the other histologic classifications included mucoepidermoid carcinoma, myoepithelial carcinoma, polymorphous low-grade adenocarcinoma, adenocarcinoma and malignant pleomorphic adenoma. Pulmonary metastasis and tumor recurrence were the main death reasons. Eleven patients remain alive and well 34-312 months (median 108) after treatment.

Malignant sublingual gland tumors are extremely rare and most are adenoid cystic carcinoma. Surgery is the main treatment option. For adenoid cystic carcinoma, hematogenous spread is common, and pulmonary metastasis is a common pathway of the distant metastasis. For some patients having lung metastasis, regional control is also important as there are some examples of patients surviving many years with asymptomatic pulmonary metastases. Postoperative radiation therapy may be adjuvant for selected patients with high-stage and high-grade tumors, or when there is concern about the inadequacy of the resection. The effect of chemotherapy remains elusive.