Dedifferentiated Acinic Cell Carcinoma of Parotid and its Treatment: A Rare Case Report

Öz

Acinic cell carcinoma is a rare variant of neoplastic lesions in the parotid gland. It is more frequent in women and commonly seen in the 4th-5th decades of life. The most common presentation of the condition is a painless and slow growing mass over the parotid gland. Majority of the acinic cell carcinomas are located on the superficial lobe of the gland. Primary treatment modality is surgery and the prognosis of the tumour is generally favorable. Histological grading should be kept in mind in the treatment of the condition. Histological subtypes of the tumour are papillary, cystic, and follicular and other variants have good prognosis. A rare form of the tumour is dedifferantiated variant which can be transformed into high grade tumours. The differantiated acinic cell carcinoma is more aggressive than the other forms and recurrent perineural and perilymphatic invasion and, therefore, systemic metasthasis are more common. In this article, the management of a 77-year-old case of dedifferentiated acinic cell carcinoma, who was admitted with the complaint of mass over the right parotid gland for one year, is presented along with the relevant literature.

Key Words: Acinic Cell Carcinoma; Parotid Gland; Salivary Gland Neoplasms; Parotidectomy.

Anahtar Kelimeler

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Journal of Turgut Ozal Medical Center

Öz

Asinik hücreli karsinom parotis bezinde nadir görülen bir neoplazidir. Kadınlarda ve sıklıkla 40-50 yaşları arasında görülmektedir. Klinikte genellikle ağrısız yavaş büyüyen kitle şeklinde bulgu verir. Asinik hücreli karsinomların büyük kısmı parotisin yüzeyel lobunda yerleşir. Tedavisi cerrahi olup, iyi prognoza sahip tümörlerdir. Bu tümörlerin tedavisinde histolojik evreleme göz önünde bulundurulmalıdır. Histopatolojik olarak papiller, kistik, folliküler ve iyi prognozlu çeşitleri bulunmaktadır. Çok nadir olarak yüksek dereceli tümörlere dönüşen dediferansiye formu bulunmaktadır. Dediferansiye türleri klasik türlerine göre daha agresiftir; rekürrens, perinöral ve perilenfatik invazyon ile bunlara bağlı sistemik metastazlar daha sıktır. Bu yazıda sağ parotis bezinde bir yıldır olan kitle yakınması ile başvuran ve dediferansiye asinik hücreli karsinom tanısı koyulan 77 yaşındaki bir hasta ve yönetimi sunularak konu literatür bilgileri eşliğinde tartışıldı

Anahtar Kelimeler

• Asinik Hücreli Karsinom, Parotid Bezi, Tükrük Bezi Neoplazileri, Parotidektomi

Kaynakça

1. Hoffman HT, Karnell LH, Robinson RA, Pinkston JA, Menck HR. National Cancer Data Base report on cancer of the head and neck: acinic cell carcinoma. Head Neck. 1999;21:297-309.
2. Kim SA, Mathog RH. Acinic cell carcinoma of the parotid gland: a 15-year review limited to a single surgeon at a single institution. Ear Nose Throat J. 2005;84(9):597-602
3. Harbo G, Bundgaard T, Pedersen D, Søgaard H, Overgaard J. Prognostic indicators for malignant tumours of the parotid gland. Clin Otolaryngol Allied Sci. 2002;27(6):512-6.
4. Henley JD, Geary WA, Jackson CL, Wu CD, Gnepp DR. Dedifferentiated acinic cell carcinoma of the parotid gland: a distinct rarely described entity. Hum Pathol. 1997;28(7):869-73.
5. Stanley RJ, Weiland LH, Olsen KD, Pearson BW. Dedifferentiated acinic cell (acinous) carcinoma of the parotid gland. Otolaryngol Head Neck Surg. 1988;98(2):155-61.
6. Costa AF, Altemani A, Hermsen M. Current concepts on dedifferentiation/high-grade transformation in salivary gland tumors. Patholog Res Int. 2011;2011:325965.
7. 7. González-Peramato P, Jiménez-Heffernan JA, López-Ferrer P, Vicandi B, Viguer JM. Fine needle aspiration cytology of dedifferentiated acinic cell carcinoma of the parotid gland: a case report. Acta Cytol. 2006;50(1):105-8.
8. 8. Ska´lova´ A, Sima R, Vanecek T, et al. Acinic cell carcinoma with high-grade transformation: a report of 9 cases with immunohistochemical study and analysis of TP53 and HER-2/neu genes. Am J Surg Pathol. 2009;33:1137–45.

9. 9. Li J, Gong X, Xiong P, Xu Q, Liu Y, Chen Y, Tian Z. Ultrasound and computed tomography features of primary acinic cell carcinoma in the parotid gland: A retrospective study. Eur J Radiol. 2014;83(7):1152-6.
10. 10. Suh SI, Seol HY, Kim TK, Lee NJ, Kim JH, Kim KA, Woo JS, Lee JH. Acinic cell carcinoma of the head and neck: radiologic-pathologic correlation. J Comput Assist Tomogr. 2005;29(1):121-6.
11. 11. Cha W, Kim MS, Ahn JC, Cho SW, Sunwoo W, Song CM, Kwon TK, Sung MW, Kim KH. Clinical analysis of acinic cell carcinoma in parotid gland. Clin Exp Otorhinolaryngol. 2011;4(4):188-92.
12. 12. Hickman RE, Cawson RA, duffy SW. The prognosis of specific types of salivary gland tumors. Cancer 1984;54:1620-4.