TITLE- Case report of An Adenoid Cystic Carcinoma: A diagnostic Enigma
INTRODUCTION: Adenoid cystic carcinoma is a slow growing but aggressive neoplasm with remarkable capacity for
recurrence which is charcaterized by proliferation of ductal and myoepithelial cells
CLINICAL DESCRIPTION:
CLINICAL FEATURES: IMMUNOHISTOCHEMISTRY GROSS FINDINGS - Greyishwhite in
MATERIAL AND METHODS:
AND SPECIAL STAINS: colour, firm in consistency, cystic in
Patient had a history of trauma
specimen received in formalin The tumor cells demonstrated diffuse areas
1 year back and had a history MICROSCOPIC DESCRIPTION-
measuring 2.4x2.3x1.1 cm Specimen cytoplasmic positivity for
of extra oral swelling Histology shows a well-circumscribed,
was sectioned into 4 sections. CK7 , SMA , S-100 The tumor ductal
in the left cheekregion 1 year back. cells also exhibited intense positivity
encapsulated tumor with
specimen submitted for processing. basaloid cell strands and islands.
Patient complaint of swelling in for pan-cytokeratin (CK),
the left cheek region for the past week. Round spaces with basophilic
and diffuse nuclear positivity for p63
material form a classic “Swiss cheese”
patternCapsular invasion and
peritheliomatous arrangement are evident.
FINAL DIAGNOSIS:
CONCLUSION:
Pediatric occurrence of Adenoid Cystic Pediatric occurrence of
Carcinoma in the buccal mucosa is Adenoid Cystic Carcinoma
exceedingly rare. This case emphasizes the in the buccal mucosa is exceedingly rare.
need for high clinical suspicion in This case emphasizes the need for high
persistent oral lesions, even with clinical suspicion in persistent oral lesions,
a prior trauma history. even with a prior trauma history.
Complete surgical excision ensured favorable
Complete surgical excision ensured favorable
outcomes in this patient. However, due to
outcomes in this patient. However,
ACC’s well-known potential for perineural
due to ACC’s well-known potential for
spread and late recurrence,
perineural spread and late recurrence,
long-term follow-up remains essential.
long-term follow-up remains essential. adenoid cystic carcinoma showing basaloid
Figure 1a-Basement membrane shown using PAS stain Figure 1b- tumor cells with hyperchromatic nuclei
REFERENCES
[Link] RH, Zhang CY, Wang LZ, et al. Adenoid cystic carcinoma in
children and young adults: A clinicopathological study of 12 cases.
Oral Dis. 2023;29(8):3289-3297.
[Link] AL, Li C, Liang J, et al. Adenoid cystic carcinoma of the
parotid and submandibular glands in children and young adults: Sweta
A population-based study. Pediatr Blood Cancer. 2024;71(5) rd
a) surgical excision of tumor mass
BDS 3 year
b) oral cavity after tumor removal
c)encapsulated and well-circumscribed tumor mass