Adenoid Cystic Carcinoma of the Lip: A Case Report

Adenoid cystic carcinoma (ACC) is an uncommon malignancy arising from secretory glands. While most commonly involving the parotid and submandibular glands, it can arise from any of the minor salivary gland tissue in the upper aerodigestive tract. This report features a more uncommon presentation of ACC in a 69 y.o. gentleman with a mass in his upper lip. Initial CT scan with contrast was concerning for an invasive lesion which subsequently led to a guideline-driven workup including fine-needle aspiration that was concerning for suspected salivary gland malignancy, most likely ACC. Pre-treatment chest CT was negative for metastatic disease. The patient underwent surgical excision followed by radiation therapy for definitive treatment. Surgical pathology confirmed a diagnosis of ACC with perineural invasion. The patient was treated with radiation therapy to minimize risk of tumor recurrence. Due to high prevalence for late recurrence and lung metastasis in patients with adenoid cystic carcinoma, the patient will be seen for ongoing surveillance including imaging. This case report looks to describe a more uncommon presentation of ACC and reviews the literature for management of ACC involving the minor salivary glands.