Adenoid Cystic Carcinoma - A Tumor of Salivary Glands

Introduction

Adenoid cystic carcinoma is a rare tumor more prevalent in women than in men. Although its etiology is unknown, a few causes can still lead to its occurrence. It is mainly associated with salivary glands, but can also affect the lacrimal gland (tear gland), the skin, scalp, middle ear, larynx, respiratory tract, breast, prostate, and cervix. This topic describes adenoid cystic carcinoma, its symptoms, diagnosis, and treatment.

What Is Adenoid Cystic Carcinoma?

Adenoid cystic carcinoma is a cancer of the salivary gland. It also affects the ascending structures which are present adjacent to salivary glands like the mouth, neck, and throat, including the tear glands, which can also get affected. Adenoid cystic carcinoma is a slow-growing carcinoma that can go through the other body parts, including the skin, breast, cervix, or prostate gland. Actually, this tumor is solid, round, and hollow. It is not a common type of cancer.

Who Gets Affected by Adenoid Cystic Carcinoma?

Mostly adenoid cystic carcinoma affects people between the ages of 40 to 60 years. But it has been reported that the condition is more prevalent in women than men. Women are affected more than men because women have some of the specific sites that can easily form or develop carcinoma, like breast tissues and cervix region, than men with mostly prostate.

Where Is Adenoid Cystic Carcinoma Present?

Adenoid cystic carcinoma primarily develops from the salivary glands with secretory cells in them. But it has a tendency to develop on other parts like the hard palate, lacrimal glands, tongue, pharynx, and larynx, with an external auditory canal (ear). It has also been reported that it can originate in other body parts instead of the head and neck. For example, breast tissues, reproductive tract, skin, cervix, and prostate.

What Are the Symptoms Related to Adenoid Carcinoma?

Symptoms related to adenoid carcinoma are:

Adenoid cystic carcinoma can easily affect other body parts. So, the symptoms are also related to significant body parts affected by it.

• If adenoid cystic carcinoma develops over the salivary gland, then symptoms are facial pain, drooping, and numbness over the areas of the lip and adjacent face.

• If adenoid cystic carcinoma develops over the lacrimal gland, then the patient can suffer vision changes, bulging of an eye as proptosis, pain, and swelling over the area.

• If adenoid cystic carcinoma is present on the skin, then it affects mostly the scalp region and the external ear canal. Some symptoms associated with these are pain, pus, and bleeding with an increased sensitivity and hair loss over the affected area.

• If adenoid cystic carcinoma develops over the lower respiratory tract, then it can affect mucous glands of the trachea with a blockage of the windpipe. Along with this, it also causes difficulty in breathing, stridor, and hoarseness of voice.

• If adenoid cystic carcinoma is present in the larynx, then it can easily affect the voice box called the larynx. The symptoms associated with these are shortness of breath, difficulty in breathing, hoarseness, voice changes, sore throat, difficulty in swallowing, mass over the neck region, and pain over the associated area.

• If adenoid cystic carcinoma is present over the esophagus, it can show difficulty swallowing foods and liquids, with regurgitation of liquid and food and weight loss.

• Suppose adenoid cystic carcinoma is present over the breast tissues, in that case, it will not be aggressive but can form a moveable mass in the associated breast only and can be near the areola.

• Suppose the adenoid cystic carcinoma of the cervix is present, in that case, it can be very aggressive and can show masses over the areas of the cervix, but it is usually present after menopause. The symptoms associated with those are vaginal discharge with bleeding and pain in the associated area.

• If the adenoid cystic carcinoma of the prostate develops, then it can develop into prostate adenocarcinoma. These have a very high potential for frequent urination and poor urinary output.

What Are the Causes of Adenoid Cystic Carcinoma?

Adenoid cystic carcinoma causes are ideally not known. But still, two factors that have been reported with this carcinoma are:

• Severe mutations in chromosomes.

• Age factors.

How Does Adenoid Cystic Carcinoma Spread?

Adenoid cystic carcinoma spreads through the bloodstream and lymph nodes. It also even metastases and spreads to other body parts like lungs, kidneys, etc. Mostly it affects the lungs on metastasizing, where it shows slow growth. It can be very aggressive in spreading through nerves. As the chances of recurrence increase in those cases and it becomes difficult to treat the carcinoma.

How Is Adenoid Cystic Carcinoma Diagnosed?

Carcinoma is diagnosed by various means:

• Biopsy: It is the possible step taken by the doctor to diagnose it; in this, a small part of the carcinoma is taken as a sample and sent to the laboratory for pathological evaluation.

• CT Scan: A CT (computerized tomography) scan can take a lot of X-rays together and the abnormalities in the internal organs are identified. Hence it is used.

• Magnetic Resonance Imaging: It uses magnetic waves to produce images of the body.

• PET (Positron Emission Tomography) Scan: It uses a radiotracer to present the functioning of the other organs.

How Is Adenoid Cystic Carcinoma Treated?

The treatment of adenoid cystic carcinoma is surgery. Further, after surgery, the patient may require radiation therapy also.

• Surgery is done to remove the tumor and sometimes surrounding body tissues also.

• Sometimes, the tumor is large, so the doctor might recommend radiation therapy.

• And if the tumor has spread to lymph nodes or nerves, it must be removed.

As radiation therapy is used as a treatment modality, it has a few side effects such as dry mouth, nausea, vomiting, hair loss, difficulty swallowing, and dental cavities.

Conclusion

Adenoid cystic carcinoma is a very rare tumor of salivary glands, which can spread to the head and neck, and other body parts. However, the cause of it is unknown. It is more prevalent in women than men. And, it can cause metastasis also to other body parts and even can show recurrence. It can be curable by undergoing surgery followed by radiation therapy. Although the surgery depends upon the region it has affected, the radiation has also shown side effects on curability. Nevertheless, with appropriate diagnosis and treatment, the living condition of the patient can be improved.