•

• References:• http://medind.nic.in/iaa/t13/i12/

iaat13i12p631.pdf

• A 25-year-old male presented to the ENT OPD with history of swelling of the left side of the cheek since 2-3 years, which gradually kept on increasing to attain the present size. Patient had no evidence of the facial nerve abnormality.

• On Examination:• Swelling present on the left side of the cheek. Soft to

firm on palpation, mobile, no rise of local temperature, facial nerve was normal.

• Histology:• Multiple sections show parotid tissue with focally

microcystic and papillary cystic glands lined by acinic cells displaying granular cytoplasm and focally clear, vacuolated cells, surrounding stroma contains lymphoid aggregates, hemorrhage and hemosiderin pigments. Few areas show laminated concretions like psammoma bodies within the lumina.

• Dx?•

• CASE

• Acinic Cell Adenocarcinoma

• A malignant epithelial neoplasm in which the neoplastic cells express acinar differentiation.

• - Location: most frequently in the parotid gland. • - Clinical presentation: slow growing.• - Histology: Serous acinar cells, which are most

characteristic of Acinic cell adenocarcinoma, are large, polygonal cells with abundant and lightly basophilic and granular cytoplasm. Dense, blue-purple, fine to coarse zymogen granules are seen.

• - DDx: Adenocarcinoma, not otherwise specified (NOS). • - Tx: Excision. Most deep parotid tumors require

postoperative radiation therapy because of the limitations in resection of these tumors, or radiation therapy is given as additional therapy for tumors that are intermediate or high grade.

• - Prognosis: They are usually low grade, but how far they have grown into nearby tissue is probably a better predictor of a patient’s prognosis.

• References: • http://www.cancer.org/cancer/salivaryglandcancer/detailedguide/salivary-gland-cancer-what-is-salivary-gland-cancer• http://lester-thompson.com/articles/ENTJ/ENTJ-2010-10_Salivary%20gland%20acinic%20cell%20carcinoma.pdfhttp://medind.nic.in/iaa/t13/i12/iaat13i12p631.pdf