Abstract
Adenoid cystic carcinoma (ACC) is a rare infiltrative tumor predominantly affecting minor salivary gland along with submandibular and parotid glands. Its biological behavior has not been clearly understood, and only few researches have been performed regarding treatment options. Patient usually presents with swelling of salivary gland region with complaints of paresthesia, numbness, and pain or muscle weakness due to nerve involvement. Diagnosis is confirmed on histopathology, and surgical excision is the treatment of choice in resectable cases. The role of neoadjuvant chemotherapy or radiotherapy remains debatable in advanced presentation. Present case depicts the role of chemotherapy and radical surgery in its management. Here, we present a case of recurrent locally advanced ACC that was down staged and underwent R0 resection after neoadjuvant chemotherapy (NACT). After two and half years of follow-up, the patient is alive and disease-free. Adenoid cystic carcinoma (ACC) is a rare and aggressive variant of salivary gland neoplasm. Perineural invasion and resistance to present chemotherapeutic drugs makes treatment more challenging. Role of chemotherapy remains controversial and in upfront technically unresectable cases neoadjuvant chemotherapy (NACT) can be used as an option to achieve R0 resection.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
Data Availability
Complete transparency maintained and files uploaded in supplementary material.
Code Availability
Not applicable.
References
To VSH, Chan JYW, Tsang RKY, Wei WI. Review of salivary gland neoplasms. ISRN Otolaryngol. 2012;1–6.
Gandhi AK, Roy S, Biswas A, Bhasker S, Sharma A, Thakar A, et al. Adenoid cystic carcinoma of head and neck: a single institutional analysis of 66 patients treated with multi-modality approach. Indian J Med Paediatric Oncol. 2015;36:166–71.
Balamucki CJ, Amdur RJ, Werning JW, Vaysberg M, Morris C, Kirwan J, et al. Adenoid cystic carcinoma of the head and neck. Am J Otolaryngol. 2012;33:510–8.
Papaspyrou G, Hoch S, Rinaldo A, Rodrigo JP, Takes RP, Van Herpen C, et al. Chemotherapy and targeted therapy in adenoid cystic carcinoma of the head and neck: a review. Head and Neck. 2011;33:905–11.
Patil VM, Prabhash K, Noronha V, Joshi A, Muddu V, Dhumal S, et al. Neoadjuvant chemotherapy followed by surgery in very locally advanced technically unresectable oral cavity cancers. Oral Oncology. 2014;50(10):1000–4.
Dodd RL, Slevin NJ. Salivary gland adenoid cystic carcinoma: a review of chemotherapy and molecular therapies. Oral Oncology. 2006;42(8):759–69.
Simpson JR, Thawley SE, Matsuba HM. Adenoid cystic salivary gland carcinoma: treatment with irradiation and surgery. Radiology. 1984;151:509–12.
Stennert E, Kisner D, Jungehuelsing M, Guntinas -Luchisus O, Schroder U, Eckel H., et al. High incidence of lymph node metastasis in major salivary gland cancer. Arch Otolaryngol. 2003;129(7):720–3.
Agarwal JP, Jain S, Gupta T, Tiwari M, Laskar SG, et al. Intraoral adenoid cystic carcinoma: prognostic factors and outcome. Oral Onco. 2008;44(10):986–93.
Kokemueller H, EckardtA BP, Hausamen JE. Adenoid cystic carcinoma of the head and neck – a 20 year experience. Int J Oral maxillofac surg. 2004;33(1):25–31.
Dhumal S, Chandrasekharan A, Patil V, Noronha V, Joshi A, Puranik A, Rangarajan V, Prabhash K. Neoadjuvant chemotherapy in technically unresectable adenocarcinoma of parotid. South Asian J Cancer. 2019;08(03):185–8.
Imaue S, Tomihara K, Hamashima T, Tomiava G, Nomura K, Sasahara M, Noguchi M. Successful multimodal treatment of intraoral salivary duct carcinoma in a patient with multiple lymph node metastasis: a case report. World J surgical. Oncology. 2017:15–8.
Author information
Authors and Affiliations
Contributions
S. No.ContributionAuthor 1Author 2Author 3Author 4
1Concepts√√--
2Design√√√√
3Definition of intellectual content√√√-
4Literature search√√-√
5Clinical studies√√-√
6Experimental studies√√-√
7Data acquisition√√√-
8Data analysis√√--
9Statistical analysis----
10Manuscript preparation√√--
11Manuscript editing√√√√
12Manuscript review√√√√
13Guarantor/final approval√√√√
Corresponding author
Ethics declarations
Ethics Approval
Obtained (Human research ethics committee – Geetanjali Hospital). Registration number: ECR/623/Inst/RJ/2014/RR-20.
Consent to Participate
Obtained.
Consent for Publication
Complete anonymity of study participant has been maintained and written informed consent obtained as well for publication.
Conflict of Interest
The authors declare no competing interests.
Additional information
Publisher’s Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
This article is part of the Topical Collection on Surgery
Rights and permissions
Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.
About this article
Cite this article
More, V.K., Jakhetiya, A., Pandey, A. et al. Neoadjuvant Chemotherapy as a Viable Treatment Option for Locally Advanced Adenoid Cystic Carcinoma of Salivary Gland: a Case Report. SN Compr. Clin. Med. 5, 86 (2023). https://doi.org/10.1007/s42399-023-01429-9
Accepted:
Published:
DOI: https://doi.org/10.1007/s42399-023-01429-9