2018-19 Section 7-Neoplastic and Inflammatory Diseases of the Head and Neck eBook

C.

Sua´rez

et

al.

/ Auris Nasus

Larynx

43

(2016)

477–484

z Department aa Consultant

of

Pathology,

Allegiance Health, Southern California

Jackson, MI, USA

Pathologist, Permanente Medical Group, Woodland Hills, CA, USA ab Department of Head and Neck Surgery, Head and Neck Oncology Program, St Luc University Hospital and King Albert II Cancer Institute, Brussels, Belgium ac Department of Pathology, Radboud University Medical Center, Nijmegen, The Netherlands ad Otorhinolaryngology-Head and Neck Surgery, University Hospitals Leuven and KU Leuven, Department of Oncology, Section Head and Neck Oncology, Leuven, Belgium ae Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA af Department of Pathology, Beth Israel Medical Center, New York, NY, USA ag Department of Pathology, Charles University in Prague, Faculty of Medicine in Plzen, Plzen, Czech Republic ah Coordinator of the International Head and Neck Scientific Group

A

R

T

I

C

L

E

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N

F

O

A

B

S

T

R

A

C

T

Article

history:

The

purpose

of

this

study was

to

suggest

general

guidelines

in

the management

of

the N0

neck

of

8

January

2016

Received Accepted Available

oral cavity

and oropharyngeal

adenoid cystic carcinoma

(AdCC)

in order

to

improve

the

survival of

19

February

2016

and/or

reduce

the

risk of neck

recurrences. The

incidence of

cervical node metastasis

these patients

online

24 March

2016

at diagnosis of head

and neck AdCC

is variable, and

ranges between 3% and 16%. Metastasis to the

cervical

lymph nodes of

intraoral

and oropharyngeal AdCC varies

from 2%

to 43%, with

the

lower

Keywords: Carcinoma Adenoid

rates may

pertaining

to

palatal AdCC

and

the

higher

rates

to

base

of

the

tongue. Neck

node

recurrence treatment

happen

after

treatment

in

0–14%

of AdCC,

is

highly

dependent

on

the

extent

of

the

cystic

and

is

very

rare

in

patients who

have

been

treated with

therapeutic

or

elective

neck

dissections,

or in

nodes

Lymph

elective

neck

irradiation.

Lymph

node

involvement

with

or

without

extracapsular

extension

dissection

Neck

has

been

shown

in most

reports

to

be

independently

associated with

decreased

overall

and

AdCC

Recurrence Risk factors

cause-specific

survival,

probably

because

lymph

node

involvement

is

a

risk

factor

for

subsequent neck AdCC

distant metastasis. The

overall

rate of

occult

neck metastasis

in

patients with

head

and

from

15%

to

44%,

but

occult

neck metastasis

from

oral

cavity

and/or

oropharynx

seems

to

ranges

occur more

frequently

than

from

other

locations,

such

as

the

sinonasal

tract

and major

salivary

glands. Nevertheless,

the

benefit

of

elective

neck

dissection

(END)

in AdCC

is

not

comparable

to

that

of

squamous

cell

carcinoma,

because

the main

cause

of

failure

is

not

related

to

neck

or

local

rather,

to distant

failure. Therefore, END should be considered

in patients with a cN0

recurrence, but neck with AdCC

in

some

high

risk

oral

and

oropharyngeal

locations when

postoperative RT

is

not

planned,

or

the

rare AdCC-high

grade

transformation. 2016

Elsevier

Ireland

Ltd. All

rights

reserved.

1.

Introduction

that are most numerous

in

the mouth, particularly

salivary glands

the palate, and

in

the oropharynx at

the base of

the

tongue.

It

is is

in

salivary

gland

neoplasms distributed

arise

from

mucoserous

Minor

presence

of

these

widely

dispersed

minor

glands

that

the

that

are

widely

throughout

the

upper

glands

for

the occurrence of

the spectrum of salivary

tumors cavity

responsible

aerodigestive

tract. While

most

parotid

gland

neoplasms

are

sites

such

as

the

oral

cavity,

oropharynx,

larynx,

nasal

at

most

minor

salivary

gland

neoplasms

are

malignant. tumors are

benign,

paranasal

sinuses. The most

common malignant

histologic

and

in the parotid gland, approximately only 15%of

Thus,

are

adenoid

cystic

carcinoma

(AdCC)

(24–70%)

and

types

30–40%

are malignant

in

the

submandibular

malignant, while

mucoepidermoid carcinomas

(11–39%). Other subtypes, such as

and

in

minor

salivary

glands glands

as

a

group

45–50%

are are

glands,

acinic

cell

carcinoma, myoepithelial

carcino-

adenocarcinoma,

In

the

sublingual

as

much

as

90%

malignant. malignant.

and

malignant

mixed

tumor

(carcinoma

arising

from

ma,

Typically,

there

are

between

500

and

1000

minor

adenomas),

occur

less

frequently

[1–5]

( Table

1 ).

pleomorphic

Table 1 Distribution

of malignant minor

salivary

gland

tumors

by

histology

and

location.

Other

(%)

Mucoepidermoid carcinoma (%)

types

(%)

Oral (%)

cavity

Oropharynx (%)

Sinonasal

(%)

Other locations(%)

No.

AdCC

Lee

et

al.

[1]

60 38 103 72 90 58 67 16 103 48

(63)

11 20 10 26 37

(18)

11 11 22 23 18

(18)

33 55 35

(55)

16 12 10

(27)

11 16 39

(18)

–

et

al.

[2]

(69.9)

(19.4)

(10.7)

(53.4)

(11.6)

(15.5)

20

(19.4)

Jones

et

al.

[3]

(64) (24)

(11) (39)

(24) (34)

(39)

(11)

(43)

6

(7)

Zeidan

et

al.

[4]

Iyer

et

al.

[5]

(46.6)

(35.9)

(17.5)

Li

AdCC,

adenoid

cystic

carcinoma.

27