Cervical Lymph Node Metastasis in High-Grade Transformation of Head and Neck Adenoid Cystic Carcinoma: A Collective International Review

• Published in: Advances in therapy Vol. 33; no. 3; pp. 357 - 368
• Main Authors: Hellquist, Henrik, Skálová, Alena, Barnes, Leon, Cardesa, Antonio, Thompson, Lester D. R., Triantafyllou, Asterios, Williams, Michelle D., Devaney, Kenneth O., Gnepp, Douglas R., Bishop, Justin A., Wenig, Bruce M., Suárez, Carlos, Rodrigo, Juan P., Coca-Pelaz, Andrés, Strojan, Primož, Shah, Jatin P., Hamoir, Marc, Bradley, Patrick J., Silver, Carl E., Slootweg, Pieter J., Vander Poorten, Vincent, Teymoortash, Afshin, Medina, Jesus E., Robbins, K. Thomas, Pitman, Karen T., Kowalski, Luiz P., de Bree, Remco, Mendenhall, William M., Eloy, Jean Anderson, Takes, Robert P., Rinaldo, Alessandra, Ferlito, Alfio
• Format: Journal Article
• Language: English
• Published: Cheshire Springer Healthcare 01-03-2016
• Subjects: Adult; Carcinoma, Adenoid Cystic - mortality; Carcinoma, Adenoid Cystic - pathology; Carcinoma, Adenoid Cystic - surgery; Cardiology; Endocrinology; Female; Health technology assessment; Humans; Internal Medicine; Lymph Nodes - pathology; Lymphatic Metastasis - pathology; Male; Medicine; Medicine & Public Health; Middle Aged; Oncology; Pharmacology/Toxicology; Review; Rheumatology; Salivary Gland Neoplasms - mortality; Salivary Gland Neoplasms - pathology; Salivary Gland Neoplasms - surgery; Salivary glands; Dedifferentiation; Local recurrence; Lymphatic metastasis; Neoplasm recurrence; High-grade transformation; Neck dissection; Adenoid cystic carcinoma; Fatal outcome
• ISSN: 0741-238X; 1865-8652
• DOI: 10.1007/s12325-016-0298-5

Adenoid cystic carcinoma (AdCC) is among the most common malignant tumors of the salivary glands. It is characterized by a prolonged clinical course, with frequent local recurrences, late onset of metastases and fatal outcome. High-grade transformation (HGT) is an uncommon phenomenon among salivary carcinomas and is associated with increased tumor aggressiveness. In AdCC with high-grade transformation (AdCC–HGT), the clinical course deviates from the natural history of AdCC. It tends to be accelerated, with a high propensity for lymph node metastasis. In order to shed light on this rare event and, in particular, on treatment implications, we undertook this review: searching for all published cases of AdCC-HGT. We conclude that it is mandatory to perform elective neck dissection in patients with AdCC-HGT, due to the high risk of lymph node metastases associated with transformation.