Parotis bezinin asinik hücreli karsinomu

Rölatif olarak erken yaşlarda ortaya çıkan ve diğer tükrük bezlerinden çok parotid glandın düşük gradeli kanserlerinden olan asinik hücreli karsinom erişkin tükrük bezi kanserleri içinde en sık görülen üçüncü epitelyal kanserdir. Daha çok kadınlarda görülmektedir. Parotid bölgede yavaş büyüyen kitle öyküsü en sık görülen semptomdur. Rekürrens ve lenf nodu metastazları belirgindir ve agresif bir büyümeye sahip olabilir. Dolayısıyla tedavi sonrası yakın takip zorunludur. Bu çalışmada 15 yaşında, sağ maksillofasial bölgede palpabl kitle şikayeti ile başvuran hasta sunulmuştur. Radyolojik görüntülemede kitlenin parotisten kaynaklandığı saptandı. İnce iğne aspirasyon biopsisi ile malignite ekarte edilemedi. Tümör kapsül dışına yayılmadığından ve derin loba ilerlemediğinden dolayı süperfisial parotidektomi yapıldı. Patoloji sonucu parotis glandın asinik hücreli karsinomu olarak rapor edildi. Operasyon sonrası 1 yıl içinde rekürrens ya da metastaz saptanmadı.

Acinic cell carcinoma of parotid gland

Acinic cell carcinoma ACC is the third most common epithelial malignancy of the salivary glands in adults, exhibiting a low-grade malignancy that mainly occurs in the parotid gland and at a relatively younger age than other salivary gland tumors. The cancer affects women more commonly than men. A slowly enlarging mass lesion in the tail of the parotid region is the most frequent presentation. ACC has a significant tendency to recur, to produce metastases cervical lymph nodes and lungs , and may have an aggressive evolution. Therefore, long-term follow-up is mandatory after treatment. We report the case of a 15-year-old girl presenting with a palpable mass in the right maxillofacial area. The radiologic evaluation showed a parotid mass. Malignancy could not be eliminated with fine needle aspiration biopsy. Removal of the superficial lobe of the parotid gland superficial parotidectomy was performed because the tumor was completely encapsulated by fibrous tissue and had not invaded the deep parotid gland. Tumour resection revealed acinic cell carcinoma of the parotid gland. There is no clinical evidence of recurrence or metastasis a year after surgery

___

  • Guzzo M, Locati LD, Prott FJ, Gatta G, McGurk M,Licitra L. Major and minor salivary gland tu- mors. Crit Rev Oncol Hematol 2010;74:134– 148
  • Luukkaa H, Klemi P, Leivo I et al. Salivary gland cancer in Finland 1991–96:an evaluation of 237 cases.ActaOtolaryngol 2005;125:207– 214
  • Boukheris H, Curtis RE, Land CE, Dores GM. Incidence of carcinoma of the major salivary glands according to the WHO classification, 1992 to 2006: a population-based study in the United States. Cancer Epidemiol Biomar- kers Prev. 2009;18(11):2899-2906
  • Barnes L, Eveson JW, Reichart P, Sidransky D, World Health Organization Classification of Tumours. Pathology and genetics of head and neck tumours, IARC Press, Lyon, 2005, 216
  • Wang YL, Zhu YX, Chen TZ. Clinicopathologic study of 1176 salivary gland tumors in a Chi- nese population: Experience of one cancer center 1997–2007. Acta Oto-Laryngologica, 2012; 132: 879–886.
  • Ellis GL, Auclair PL, Tumors of the salivary glands. Atlas of tumor pathology, 3rd Series, Fascicle 17, Armed Forces Institute of Patho- logy, Washington, D.C., 1996, 183.
  • Dardick I, Mounting evidence against cur- rent histogenetic concepts for salivary gland tumorigenesis, Eur J Morphol, 1998; 36(Suppl):257–261.
  • Dardick I, Burford-Mason AP, Current status of histogenetic and morphogenetic concepts of salivary gland tumorigenesis, Crit Rev Oral Biol Med, 1993; 4(5):639–677.
  • Sams RN, Gnepp DR. P63 expression can be used in differential diagnosis of salivary gland acinic cell and mucoepidermoid carcinomas. Head Neck Pathol. 2013;7(1):64-68.
  • Al-Zaher N, Obeid A, Al-Salam S, Al-Kayyali BS. Acinic cell carcinoma of the salivary glan- ds: a literature review. Hematol Oncol Stem Cell Ther. 2009;2(1):259-264.
  • Orvidas LJ, Kasperbauer JL, Lewis JE, Olsen KD, Lesnick TG, Pediatric parotid masses, Arch Otolaryngol Head Neck Surg, 2000; 126(2):177–184.
  • Rogers DA, Rao BN, Bowman L, et al, Primary malignancy of the salivary gland in children, J Pediatr Surg, 1994; 29(1):44–47.
  • Chou C, Zhu G, Luo M, Xue G, Carcinoma of the minor salivary glands: results of surgery and combined therapy, J Oral Maxillofac Surg, 1996; 54(4):448–453.
  • Kane WJ, McCaffrey TV, Olsen KD, Lewis JE, Primary parotid malignancies. A clinical and pathologic review, Arch Otolaryngol Head Neck Surg 1991; 117(3):307–315.
  • Andreoli MT, Andreoli SM, Shrime MG, De- vaiah AK. Radiotherapy in parotid acinic cell carcinoma: does it have an impact on sur- vival? Arch Otolaryngol Head Neck Surg. 2012;138(5):463-436.
  • Schwentner I, Obrist P, Thumfart W, Sprinzl G. Distant metastasis of parotid gland tumors, Acta Otolaryngol 2006; 126(4):340–345.
  • Tavora F, Rassaei N, Shilo K et al. Occult pri- mary parotid gland acinic cell adenocarcino- ma presenting with extensive lung metastasis, Arch Pathol Lab Med 2007; 131(6):970–973.
  • Vidyadhara S, Shetty AP, Rajasekaran S, Wi- despread metastases from acinic cell carcino- ma of parotid gland, Singapore Med J 2007; 48(1):e13–e15.
  • Lewis JE, Olsen KD, Weiland LH. Acinic cell carcinoma. Clinicopathologic review, Cancer 1991, 67(1):172–179.
  • Schwarz S, Zenk J, Müller M et al. A. The many faces of acinic cell carcinomas of the salivary glands: a study of 40 cases relating histologi- cal and immunohistological subtypes to cli- nical parameters and prognosis. Histopatho- logy. 2012;61(3):395-408.
  • Munteanu MC, Cionca L. Acinic cell carcinoma of the salivary glands: a retrospective clinico- pathologic study of 12 cases. Rom J Morphol Embryol 2012; 53(2):313–320.
  • Lin WN, Huang HC, Wu CC et al. Analysis of acinic cell carcinoma of the parotid gland - 15 years experience. Acta Otolaryngol 2010;130(12):1406-1410.
  • Batsakis JG, Luna MA, el-Naggar AK, Histopat- hologic grading of salivary gland neoplasms: II. Acinic cell carcinomas, Ann Otol Rhinol Lar- yngol 1990; 99(11):929–933.
  • El-Naggar AK, Batsakis JG, Luna MA, McLemo- re D, Byers RM. DNA flow cytometry of acinic cell carcinomas of major salivary glands, J Lar- yngol Otol 1990;104(5):410–416.
  • Guimaraes DS, Amaral AP, Prado LF, Nasci- mento AG. Acinic cell carcinoma of salivary glands: 16 cases with clinicopathologic corre- lation, J Oral Pathol Med 1989;18(7):396–399.