Basic and patient-oriented research
Acinic Cell Carcinoma of Minor Salivary Glands: A Clinical and Immunohistochemical Study

https://doi.org/10.1016/j.joms.2009.09.065Get rights and content

Purpose

Acinic cell carcinoma is a rare malignant tumor of salivary glands. The purpose of this study is to evaluate the clinical outcome of acinic cell carcinoma in a group of 11 patients, who were treated in our clinic, and to discuss the management as well as the immunohistochemical features and prognosis of this carcinoma.

Materials and Methods

The study included 11 patients with acinic cell carcinoma of the minor salivary glands who were treated in our clinic. The patients were 7 women and 4 men. The patients' age ranged from 46 to 83 years. The distribution of the primary sites was buccal mucosa (4) maxilla/maxillary sinus, etc, (2), hard palate (1), junction of soft/hard palate (1), lower lip (1), labio marginal sulcus (1), and vestibular sulcus and mandible (1). All patients were treated with surgery. Adjuvant radiotherapy was used in 3 patients. Immunohistochemical assay of expression of Ki-67, p53, EGFR, and c-erbB-2/neu markers was performed on specimens of all tumors.

Results

The mean follow-up range was 2 to 15 years. Of the 11 patients, 7 were alive (2, 3, 4, 5, and 15 years after the initial therapy). Two patients died of another cause free of the disease 9 and 10 years after the initial treatment, and 2 patients died of the disease (local recurrence, distant metastases 2 and 3 years later). Overexpression of immunohistochemical markers was evident for tumors with widespread metastases.

Conclusions

Acinic cell carcinoma is a rare malignant tumor of the salivary glands, characterized by an indolent clinical course with the potential for both local recurrence and distant metastases. The immunohistochemical analysis of proliferation markers provides additional prognostic information for this tumor.

Section snippets

Materials and Methods

In this study we describe 11 cases of ACC of minor salivary glands. The patients presented to our clinic at the “G. Papanikolaou” Hospital at Thessaloniki for further treatment of their disease. The patients were 7 women and 4 men. The patients' age ranged from 46 to 83 years. The distribution of the primary sites were: buccal mucosa (4), maxilla/maxillary sinus, etc (2), hard palate (1), junction of hard and soft palate (1), lower lip (1), labiomarginal sulcus (1), and vestibular sulcus and

Results

Mean follow-up ranged from 2 to 15 years. Of the 11 patients, 7 are alive 2, 3, 4, 5, and 15 years after the initial therapy. Two patients died of other causes free of the disease 9 and 10 years after the initial treatment, and 2 patients died of the disease (local recurrence, distant metastases 2 and 3 years later). Results of the therapeutic procedures and follow-up of the patients are analyzed in Table 1. Results of the analysis of immunohistochemical markers (ki-67, p53, c-erbB-2/new and

Discussion

Acinic cell carcinoma is histologically defined as a tumor with predominant differentiation toward serous acinar cells, variably admixed with clear, vacuolated, and intercalated ductal cells.2, 3, 6, 15 The morphological growth patterns are: solid, microcystic, papillary-cystic, and follicular. The solid and microcystic ones are the most common patterns.1, 2, 3, 16 Acinar cells are large, polygonal cells with lightly basophilic, granular cytoplasm and round, eccentric nuclei (Fig 2A). The

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