Abstract
30 cases of adenoid cystic carcinoma (ACC) in the head and neck region were studied. They were arising in 13 major salivary glands (parotid 5, submandibular 4, sublingual 4), 9 nose and paranasal sinuses (maxilla 3, maxilloethmoid 1, ethmoid 3, sphenoid 1, nasal cavity 1), 5 oral cavities (tongue base 2, floor of the mouth 2, palate 1), 1 larynx, 1 external auditory canal, and 1 unkown. The presenting symptoms were a mass without pain in 25%, mass with pain in 17.9%, and pain in 17.9%. Mean duration of symptoms was 22 months. Only three patients had Stage I, each seven patients had Stage II or III, and 13 patients had Stag IV. 23.3% of the patients died of disease, with a mean survival period of 44 months. Histologic specimens were reviewed and divided into 3 subtypes-tubular, cribriform, and solid. 3 patients had tubular subtype, 22 and 5 patients had cribriform and solid subtype. In 25 out of 28 treated cases surgery was done, with 9 of them considered as curative one. Combination chemotherapy with cyclophosphamide, adriamycin, and cis-platinum was done in 9 cases with a response rate of 11.1% (1/9). Radiation therapy was done in 8 cases in total with a response rate of 100% (2/2). Radiation therapy accompanied with chemotherapy containing cis-platium was done in 2 cases with a response rate of 50% (1/2). Cumulative survival rate for 5 and 10 year was 50% (8/16) and 16.7% (1/6) respectively. Factors which appeared to influence the clinical course included 1) presense or absence of metastasis, 2) clinical stage, with absenseof metastasis, and lower clinical stage to have better prognosis.
