Clinical Characteristics of the Adenoid Cystic Carcinoma of the Sinonasal Tracts

ABSTRACT

BACKGROUND AND OBJECTIVES: Adenoid cystic carcinoma is occasionally found, second to the squamous cell carcinoma, in the sinonasal tracts. The purpose of this study is to find out the clinical features, treatment outcome, and prognostic factors of adenoid cystic carcinoma in the sinonasal tracts. MATERIALS AND METHODS: Between September 1993 and December 2005, 16 cases of adenoid cystic carcinoma of the sinonasal tracts (6 males, 10 females, ages ranging between 35-70 years; a mean age of 49 years) were selected. We reviewed medical records of the patients to examine their clinical presentations, treatment options, and their outcomes. RESULT: The most common site of affliction was the nasal cavity (37.5%) followed by the maxillary sinus (31.3%). Patients displayed various symptoms such as nasal obstruction, facial pain, and epistaxis. Nine out of 16 patients (56%) were diagnosed to be in stage IV (AJCC staging system). Histopathological examination revealed cribriform type (13 patients 81%) and solid type (3 patients19%). In 3 patients, perineural invasion was observed. Surgery with or without postoperative radiation therapy (RT) was applied for 8 patients (stage I, II, III, IV), RT only for 7 patients (stage III, IV), and RT and chemotherapy for 1 patient (stage IV). Total recurrence rate was 43.8% (7 out of 16 patients) and the recurrence rate of the patients followed up over 5 years was 62.5% (5 out of 8 patients). CONCLUSION: Adenoid cystic carcinoma of the sinonasal tract develops more frequently among women and is usually discovered in the advanced stage. Surgery and postoperative RT are the main stay of the treatment.