Journal
ORAL ONCOLOGY
Volume 130, Issue -, Pages -Publisher
ELSEVIER
DOI: 10.1016/j.oraloncology.2022.105945
Keywords
Adenoid cystic carcinoma; Head and neck cancer; Recurrence and metastatic disease; Perineural invasion; Radiotherapy
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Funding
- National Natural Science Founda-tion of China [82171118]
- Hunan Postdoctoral Program for Innovative Talent [2021RC2017]
- Natural Science Foundation of Hunan Province [2021JJ41027]
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Adenoid cystic carcinoma (ACC) is a rare malignant tumor derived mainly from the salivary glands that displays contradictory characteristics of slow growth but aggressive progression. ACC of the head and neck (ACCHN) has a propensity for perineural invasion and is challenging to treat. This review aims to provide updated insights into ACCHN and discuss imaging diagnosis, pathological features, and therapeutic strategies.
Adenoid cystic carcinoma (ACC) is a rare malignant tumor derived mainly from the salivary glands, representing approximately 1% of all head and neck carcinomas and 10% of all salivary gland neoplasms. ACC displays a paradoxical behavioral combination of an indolent growth pattern but an aggressive progression, with local recurrence and distant metastasis. The propensity of ACC of the head and neck (ACCHN) for perineural invasion and its anatomical location, especially if it extends to the nasal cavity and paranasal sinuses, facilitates tumor involvement in the surrounding structures, such as the orbit, pterygopalatine fossa, Meckel's cave, and cavernous sinus, which can lead to skull base involvement and intracranial extension. Despite advances in molecular mechanisms and diagnostic imaging, ACC treatment remains challenging due to the lack of consensus on treatment patterns. In this review, we aimed to provide an updated insight into the understanding of ACCHN by focusing on clinical behavior, imaging diagnosis, pathological features, and therapeutic strategies. We reviewed the molecular mechanisms, especially in ACCHN with perineural invasion, and elaborated on treatment options, including chemotherapy, targeted therapies, and immunotherapy, to establish a comprehensive understanding of ACC to arrive at a policy for proper diagnosis, preoperative evaluation, and therapeutic strategies.
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