acinic cell carcinoma
a·cin·ic cell ad·e·no·car·ci·no·ma
acinic cell carcinoma
BreastAn extremely rare carcinoma that is morphologically identical to the same-named tumours of the salivary glands. There is little known about their behaviour, but they do metastasise to regional lymph nodes and may be fatal.
DiffDx
Microglandular adenosis, apocrine carcinoma.
Oral
A usually low-grade, slowly growing salivary (80% are parotid) gland carcinoma with serous acinar cell differentiation. It comprises 1% to 6% of salivary gland tumours, and 10% to 17% of all salivary gland malignancies. In some series it is more common in females, in others, men; it peaks in the 5th decade; 3% are bilateral.
Risk factors
Radiation exposure, familial predisposition, wood dust inhalation.
Staging
Outcomes are worse with larger tumours, incomplete excision, deep lobe involvement and MIB proliferation index of > 10%.
Prognosis
5-year survival, 90%; 20-year-survival, 55%; 12–35% recur, 8% metastasise.
Poor prognosticators.
Pain at presentation, fixation of tissue to other structures, gross invasion, focal necrosis, perineural invasion, histologic features: desmoplasia, atypia/pleomorphism, increased mitotic activity. Prognosis is better if the tumour nodules are well-circumscribed, microcystic and have lymphoid follicles.
Management
Usually wide local excision suffices; complete first-time surgical excision is critical to cure.