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Adenoid cystic carcinoma
1Department of Pathology and Laboratory Medicine, University of Texas Health Science Center at Houston Medical School and University of Texas Medical Center-Houston, Houston, Texas 77030-1501, USA. jesse.jaso@uth.tmc.edu
Archives of Pathology & Laboratory Medicine
|April 7, 2011
Summary
Adenoid cystic carcinoma is a rare cancer with a slow growth pattern but a high risk of recurrence and metastasis. Prognosis depends on tumor grade, stage, and treatment, with surgery and radiation offering improved control but not eliminating late risks.
Area of Science:
- Oncology
- Pathology
Background:
- Adenoid cystic carcinoma (ACC) is a malignant neoplasm with a deceptively benign histologic appearance.
- ACC is characterized by indolent, locally invasive growth, high rates of local recurrence, and distant metastasis.
Purpose of the Study:
- To review the prognostic factors and treatment outcomes for adenoid cystic carcinoma.
- To highlight the challenges in predicting prognosis based on histology and the potential of molecular markers.
Main Methods:
- Review of existing literature on adenoid cystic carcinoma.
- Analysis of histological patterns (cribriform, tubular, solid) and their prognostic significance.
- Evaluation of gene expression profiling and microarray analysis for diagnostic and prognostic markers.
Main Results:
- Histologic grading of ACC has yielded conflicting results.
- Tumor grade, stage, lymph node metastasis, nerve invasion, and margin status are consistent prognostic predictors.
- Surgery and postoperative radiation therapy improve locoregional control but do not prevent late recurrence or metastasis.
Conclusions:
- Accurate histologic prognostic features for ACC remain challenging to define.
- Molecular markers show promise but clinical factors are currently most reliable.
- Despite improved locoregional control, long-term vigilance for late recurrence and metastasis is crucial in ACC management.
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