Skip to main page content
Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2016 Mar;33(3):357-68.
doi: 10.1007/s12325-016-0298-5. Epub 2016 Feb 19.

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

Free PMC article

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

Henrik Hellquist et al. Adv Ther. .
Free PMC article


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.

Keywords: Adenoid cystic carcinoma; Dedifferentiation; Fatal outcome; High-grade transformation; Local recurrence; Lymphatic metastasis; Neck dissection; Neoplasm recurrence; Salivary glands.


Fig. 1
Fig. 1
High-grade transformation in adenoid cystic carcinoma (AdCC-HGT). a The transformed AdCC consists of sheets of atypical, cells and loss of architecture usually seen in a conventional AdCC. b AdCC-HGT with a very high labeling index with Ki-67 (left) and a much more modest Ki-67 index in the remnants of the conventional AdCC (right)

Similar articles

See all similar articles

Cited by 7 articles

See all "Cited by" articles


    1. Dahlin DC, Beabout JW. Dedifferentiation of low-grade chondrosarcomas. Cancer. 1971;28:461–466. doi: 10.1002/1097-0142(197108)28:2<461::AID-CNCR2820280227>3.0.CO;2-U. - DOI - PubMed
    1. Stanley RJ, Weiland LH, Olsen KD, Pearson BW. Dedifferentiated acinic cell (acinous) carcinoma of the parotid gland. Otolaryngol Head Neck Surg. 1988;98:155–161. doi: 10.1177/019459988809800210. - DOI - PubMed
    1. Henley JD, Geary WA, Jackson CL, Wu CD, Gnepp DR. Dedifferentiated acinic cell carcinoma of the parotid gland: a distinct rarely described entity. Hum Pathol. 1997;28:869–873. doi: 10.1016/S0046-8177(97)90164-7. - DOI - PubMed
    1. Di Palma S, Corletto V, Lavarino C, Birindelli S, Pilotti S. Unilateral aneuploid dedifferentiated acinic cell carcinoma associated with bilateral low grade diploid acinic cell carcinoma of the parotid gland. Virchows Arch. 1999;434:361–365. doi: 10.1007/s004280050353. - DOI - PubMed
    1. Skálová A, Sima R, Vanecek T, Muller S, Korabecna M, Nemcova J, Elmberger G, Leivo I, Passador-Santos F, Walter J, Rousarova M, Jedlickova K, Curik R, Geierova M, Michal M. Acinic cell carcinoma with high-grade transformation: a report of 9 cases with immunohistochemical study and analysis of TP53 and HER-2/neu genes. Am J Surg Pathol. 2009;33:1137–1145. doi: 10.1097/PAS.0b013e3181a38e1c. - DOI - PubMed

LinkOut - more resources