Adenoid cystic carcinoma of the upper lip

An elderly man had a large adenoid cystic carcinoma (ACC) of the upper lip. Because of the patient's desire not to have a major surgical resection, the primary modality of treatment was irradiation. A local recurrence following radiation therapy did require surgery, however without morbidity. During the postoperative course extreme physical deterioration of the patient necessitated a complete medical work-up. This revealed lung nodules, not seen previously, which were suspected of being malignant. A barium enema also revealed a sigmoid lesion suggestive of malignancy. Since none of the suspected distant sites were histologically examined, the course of the ACC is left to conjecture. Also, it is left to conjecture as to what course might have followed had the patient been treated initially with a surgical resection. The patient died 20 months after the original diagnosis of the lip tumor was made.