顎下腺腺様嚢胞癌６例の検討

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  • Adenoid cystic carcinoma of the submandibular gland: Report of 6 cases.

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A retrospective review of 6 patients with adenoid cystic carcinoma (ACC) of the submandibular gland treated between 1978 and 1991 was presented. Two patients who underwent aggressive surgery were disease-free, local control failed in 2 patients, and pulmonary metastasis developed in 2 patients without locoregional disease.<BR>This study supports the following conclusions:<BR>1. The perimeters of ACC are always more extensive than they appear to be clinically, because ACC has a strong tendency to invade the perineural space and extend for long distance.<BR>2. In preoperative diagnosis, aspiration cytology is essential for accurate diagnosis. Diagnostic imagings such as sialography, X-ray CT and MRI are helpful in detecting the size and extent of the tumor. RI study is indispensable in detecting the perineural spread<BR>3. Surgery is the treatment of choice, and it should be as extensive as possible, with a wide margin of healthy tissue. Radiation therapy, although not curative, plays an important role in prolonging survival and pain relief.<BR>4. ACC is characterized by slow growth, frequent recurrence, and systemic spread even after long-term survival without disease, therefore adjuvant chemotherapy should be taken into consideration.

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