• Alfio José Tincani, André Del Negro, Priscila Pereira Costa Araújo, Hugo Kenzo Akashi, Antonio Santos Martins, Albina Milani Altemani, and Gilson Barreto.
• Department of Surgery, Faculdade de Ciências Médicas, Universidade Estadual de Campinas, Campinas, São Paulo, Brazil. alfio.jt@terra.com.br
• Sao Paulo Med J. 2006 Jan 5; 124 (1): 263026-30.

Context And ObjectiveSalivary gland tumor management requires long-term follow-up because of tumor indolence and possible late recurrence and distant metastasis. Adenoid cystic carcinoma (ACC) accounts for 10-15% of such tumors. The aim here was to evaluate surgical and clinical management, staging and follow-up of ACC patients in one academic institution.Design And SettingRetrospective study at Head and Neck Service, Universidade Estadual de Campinas.MethodsData on 21 patients treated between 1993 and 2003 were reviewed. Management utilized clinical staging, histology and imaging. Major salivary gland tumor extent was routinely assessed by preoperative ultrasonography. Diagnosis, surgery type, margin type (negative/positive), postoperative radiotherapy and recurrence (presence/absence) were evaluated.ResultsThere were eleven major salivary gland tumors (52.3%), seven submandibular and four parotid. Ten patients (47.7%) had minor salivary gland ACC (all in palate), while the submandibular was the most frequently affected major one. Diagnoses were mostly via fine-needle aspiration (FNA) and incision biopsy. Frozen sections were used for six patients. There was good ultrasound/FNA correlation. Sixteen (76%) had postoperative radiotherapy. One (4.7%) died from ACC and five now have recurrent disease: three (14.2%) locoregional and two (9.5%) distant metastases.ConclusionAdenoid cystic carcinoma has locally aggressive behavior. In 21 cases, of ACC, the facial nerve was preserved in all except in the few with gross tumor involvement. Treatment was defined from physical examination, imaging, staging and histology.

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