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Review
. 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

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Free PMC article
Review

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

Abstract

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.

Figures

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)

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