Adenoid cystic carcinoma is a rare but aggressive cancer that commonly arises in salivary glands. It grows slowly but has a tendency to invade surrounding tissues and recur. Microscopically, it displays cribriform, tubular, or solid patterns composed of basaloid cells surrounding cystic spaces or forming ducts. While surgical excision is the main treatment, the cancer is difficult to cure due to its ability to spread along nerves. Prognosis is poor, especially for tumors originating in minor salivary glands.

2. Adenoid Cystic Carcinoma
 Cylindroma
 Adenocystic carcinoma
 Adenocystic basal cell carcinoma
 Pseudoadenomatous basal cell carcinoma
 Basloid mixed tumor
 •It is a slow growing but aggressive neoplasm with
remarkable capacity to reoccur and profound
tendency to invade perineural lymphatic spaces.

3. Adenoid cystic carcinoma :-
is the most common malignant neoplasm of the submandibular
and sublingual glands as well as the minor salivary glands in the palate
clinical feature
 50-70% starts in minor salivary gland
the palate is the most common site
 If major salivary gland
( parotid is the most affected– painful mass )
 Age:- 5th and 7th decades
 Gender:- no gender predilection
 (slight female predominance)
sublingual gland tumor

4. c/p :-
 - Pain is a common and important finding
 - slowly growing mass.
 - Patients often complain of a constant , low-grade, dull
ache, which gradually increases in intensity.
 - Facial nerve paralysis may develop with parotid tumors.
 - Palatal tumors can be smooth surfaced or ulcerated.
 - Tumors arising in the palate or maxillary sinus may show
radiographic evidence of bone destruction

5. Adenoid cystic carcinoma. Painful mass of the hard palate and
maxillary alveolar ridge.

6. Gross pathology
Adenoid cystic carcinoma of the
parotid gland has deceptively well delineated
outlines.
Microscopically, the tumor extends
well beyond the grossly apparent
edges of the tumor.
White or grayish white color,
firm, invasive tumor.
Areas of hemorrhage seen.

7. Histopathologic features:
The adenoid cystic carcinoma is composed of a mixture
of myoepithelial cells and ductal cells that can have a
varied arrangement.
Three major patterns are recognized;
(1) cribriform ,(differentiated)
(2) tubular, (moderately differentiated) and
(3) solid.(undifferentiated)
Usually a combination at these is seen, and the tumor is
classified based on the predominant pattern.

8. Cribriform pattern:

9. Cribriform pattern:
 The cribriform pattern is the most classic and best
recognized appearance,
 characterized by islands of basalaid epithelial cells
that contain multiple cylindrical, cyst like spaces resembling
Swiss cheese or honeycomb pattern.
 These spaces often contain a mildly basophilic mucoid
material
a hyalinized eosinophilic product , or a combined mucoid
hyalinized appearance.
 Sometimes the hyalinized material also surrounds
these cribriform islands.

10. Tubular pattern:
 Tubular structure that are lined by stratified cuboidal
epithelium.
 Longitudinal section- ductal structures are viewed as ducts or
tubules.
 The tubular Lumen can be lined by one or more several loayers of cell
Adenoid cystic carcinoma.
Tubular variant showing morphologically
clear abluminal cells.

11. Solid pattern:
 Solid groups of cuboidal cells with little tendency
towards ducts or cyst formation
 Arranged in nests or sheets of varying size and shape
 Areas of necrosis seen
 Cellular pleomorphism, mitosis observed
Solid variant higher power showing
scattered duct-like structures within
the tumor sheet.

12. Adenoid cystic carcinoma.
The tumor cells are
surrounded by hyalinized
material
Adenoid cystic carcinoma. Perineural
invasion.

13. Tublar pattern in top & bottom.
A cribriform
in the center
Epithelial cells have a clear cytoplasm,poorly
defined border & irregular shaped nuclei

14.  The tumor appear well
circumscribed
 Mitotic activity
Adenoid cystic carcinoma,

15.  Adenoid cystic carcinoma.
Perineural invasion.
 Adenoid cystic carcinoma.
The tumor cells are
surrounded by hyalinized
material

16. Treatment and prognosis
 Surgical excision
 X-ray radiation, radiation alone is not recommended
 Cure rate is low
 Minor gland tumor is more deadly than major gland