Adenoid cystic carcinoma of the head and neck: The Arkansas experience

Adenoid cystic carcinoma maintains an enigmatic reputation among head and neck neoplastic lesions. Prolonged survival in the presence of disseminated tumor burden is typical. Nodal dissemination is rare, but more commonly seen with subglottic and trachéal lesions of minor salivary origin. We report the retrospective experience with this lesion at the University of Arkansas for Medical Sciences over the past decade. Fifty three cases were identified via database, with site specific data available in 51 of these cases. Twenty eight women were treated, as were 25 men. Only 9 (9/28) were smokers or ethanol users. The average age at presentation was 53.5 years, with ten patients presenting at an age of less than forty years. Ten of fifty one patients underwent neck dissection; three of these ten exhibited pathologically positive nodal métastases. All pathologically positive nodes were palpable preoperatively. Métastases were distributed to the lung (8/51), liver (1/51) and brain (1/51). Survival results among living patients revealed an average of 93.8 months. Patients now dead exhibited an average survival of 106.5 months. Postoperative radiotherapy was advised in most cases. Our results are consistent with previous data referable to the treatment of adenoid cystic carcinoma. To improve our collective patient results, a greater push must be made in the realm of tumor biology to better understand this highly infiltrative, yet comparatively indolent neoplasm.