A case of adenoid cystic carcinoma occurred in the soft palate

a case showing interesting invasion pattern

Abstract

Adenoid cystic carcinoma accounts for about 3. 8 to 10 percent of salivary tumors, and it occurs more often in the submandibular gland and the palate. Histologically, the tumor is characterized by a cribriform pattern of tumor nests, but tubular and solid patterns were also found occasionally. Usually, a tumor with a prominent solid pattern has a poor prognosis. A case of this tumor arising from the soft palate and showing insidious invasion to both the nasal side and the oral side of the hard palate without bone destruction was reported.
The patient, a 44-year-old man, was referred to our hospital with the chief complaint of painless swelling at the left side of the soft palate. Radiological examination showed no evidence of bone destruction. The impression was a benign salivary gland tumor of the palate. Excisional biopsy was performed and the pathological examination revealed a picture of an adenoid cystic carcinoma with section line invasion. Part of the soft palate, hard palate, nasal septum and lateral wall of the pharynx were resected, and it was reconstructed by a mucoperiosteal flap from the contralateral palate. Because of a small necrosis of the flap, an oro-antral fistula occurred. Pathologically, the tumor spread along both the nasal side and the oral side of the hard palate and no bone destruction was noted.
No recurrence was noted for four years and two months after the operation.