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Clinical and Histopathological Study of Adenoid Cystic Carcinoma Occurring in the Salivary Gland.
The Second Report: Study of Lymph Node and Distant Metastasis
Kazuo Ryoke, Kazuyoshi Kawasaki, Satoshi Kataoka, Masaml Yao, Satoshi Kanoh, Kazuhiko Tanio, Tohru lrkawa, Kazumi Okamoto and Takeshi Hamada
Department of Oral and Maxillofacial Surgery, Faculty of Medicine, Tottori University, Yonago 683, Japan
Fifteen patients who had been teated for adenoid cystic carcinoma in our departnent during the past 22 years, from July 1971 to July 1993, were studied to determine the degree of lymph node and distant metastasis of the carcinomas and to identify related factors. The result were as follows: (i) Lymph node metastases were found in 4 (26.7%) of 15 cases. In 3 of these 4 cases, Iymph node metastasis had not been clinically found until histopathological examination was done. (ii) Three of the 4 cases which metastasized to the submandibular or superior cervical lymph nodes developed in the submandibular salivary gland or in the floor of the mouth. It was suggested that the tumor might directly infiltrate the lymph nodes instead of metastasizing in view of the anatomical relationship of the primary tumor and the adjacent lymph nodes and the characteristic infiltrative pattern. (iii) Lymph node metastasis tended to occur in advanced cases of T-classification and in cases of abundant solid component of tumor. (iv) Distant metastasis, which occurred in 66.7% (10 of 15 cases), developed mostfrequently in the lung followed by bone and the uterus. The relating factors were the primary site. The time at which distant metastasis was confirmed ranged from the 1st visit to 13 years and 2 months after diagnosis of the primary tumor, and the time was related to histopathological classification. The interval from lung metastasis to death or to the present was from 3 months to 5 years and 9 months, which participated in the local extension.
Key words: adenoid cystic carcinoma; clinical and histopathological study; distant metastasis; Iymph node metastasis; salivary gland tumor