Neurotrophic spread of both neuroblastoma and adenoid cystic carcinoma in the maxillofacial district: common aspects of pre- and postsurgical adjuvant treatment. Multidisciplinary study.

We have studied a common aspect of both adenoid cystic carcinoma (ACC) and neuroblastoma (NB) with the purpose of finding the optimal medical and surgical treatment. This article is based on a case study involving 22 cases of ACC and NB performed at the University of Rome La Sapienza from 1993 to 2001. Of the 22 cases, 17 were diagnosed with ACC and 5 with NB. ACC largely involved the maxillae, having been detected in this location in eight cases. Two of these patients, one affected by ACC and the other affected by NB, received neoadjuvant treatment, whereas 14 were affected by ACC, and 3 with NB received adjuvant treatment. Despite the fact that the two neoplasms have different embryogenic structures, they share common aspects. Both spread invasively through the perineural sheets, and both are responsive to radiotherapy or chemotherapy. The common biologic behavior and the similar response that both show to neoadjuvant radiotherapy or chemotherapy may suggest a way to develop a more effective treatment protocol. The aim of this article is to suggest a line of research along that path.