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Vol. 51. Issue 1.
Pages 5-11 (January - March 2010)
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Vol. 51. Issue 1.
Pages 5-11 (January - March 2010)
Caso Clínico
Open Access
Acinic Cell Carcinoma of Parotid Gland: Report of Three Cases and Literature Review
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Lucinei Roberto Oliveira*,1, Danilo Figueiredo Soave**,1, João Paulo Oliveira da Costa**,1, Alfredo Ribeiro-Silva***,1,
Corresponding author
arsilva@fmrp.usp.br

Correspondência para:.
* Research Scientist, DDS, PhD
** DDS, MSc Student
*** Professor, MD, PhD
1 Department of Pathology, Ribeirão Preto Medical School, University of São Paulo
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Abstract

Primary Acinic Cell Carcinoma (ACC) is an uncommon salivary gland (SG) tumor, making up 1% of all SG neoplasms. The parotid is the most common topography, and the ACCs are more frequently diagnosed in the fourth to sixth decades of life. In this study, along with a brief review of the literature, we discussed the clinical, histopathological, and prognostic features of these SG tumors through three reported cases. All of the tumors occurred in left parotid of non-smoking and non-drinking white patients, aging 80, 51, and 56 years. The lesions were painless and presented as slow-growing, large, firm, and movable solitary masses in the left mandible angle. The patients were initially submitted to a clinical, radiographic and computed tomography exam, followed by fine-needle aspiration and an excisional biopsy to confirm the diagnosis. All of the patients were treated with surgery followed by radiotherapy. Two of the patients had a local recurrence, one of which had cervical lymph node involvement, but both are still alive. The other patient did not have a local recurrence or lymph node involvement, but developed distant pulmonary metastases and died. The follow-up times were 18, 102 e 22 (with death) months. Upon histopathological analysis, ACC typically shows a solid pattern of growth, with cells exhibiting serous acinar cell differentiation and cytoplasmic basophilic granules. Complete surgical resection is the usual therapeutic choice. The literature describes ACC as a tumor with low malignant potential, but several recurrences and metastasis have been reported, as verified in the present study.

Key-words:
Acinic Cell Carcinoma
Oral Cancer
Parotid gland
Psammoma bodies
Salivary gland tumor
Resumo

O Carcinoma de Células Acinares (CCA) é um tumor incomum das glândulas salivares (GS), perfazendo 1% de todas as neoplasias de GS. A parótida é a localização mais comum, e os CCAs são mais frequentemente diagnosticados entre a quarta e sexta décadas. No presente estudo, junto com uma breve revisão da literatura, foram discutidas as características clínicas, histopatológicas e prognósticas destes tumores através do relato de três casos. Todos os tumores ocorreram na glândula parótida esquerda de pacientes leucodermas, não fumadores e sem hábitos de bebida, com idades de 80, 51 e 56 anos. As lesões eram assintomáticas e apresentaram-se como uma grande massa única de crescimento lento, endurecida e móvel, no ângulo mandibular esquerdo. Os pacientes foram inicialmente submetidos aos exames clínico, radiográfico e tomográfico, seguidos de aspiração por agulha fina e biópsia excisional para confirmação do diagnóstico. Todos os pacientes foram tratados com cirurgia seguida de radioterapia. Dois pacientes tiveram recidivas, um deles com envolvimento de linfonodos cervicais, porém ambos ainda estão vivos. O outro paciente não apresentou recidiva ou envolvimento linfonodal, mas desenvolveu metástases pulmonares e foi a óbito. Os tempos de acompanhamento foram de 18, 102 e 22 (com óbito) meses. Ao exame histopatológico, os CCAs demonstraram um típico padrão de crescimento sólido, com células exibindo diferenciação acinar serosa e grânulos basofílicos no citoplasma. A ressecção cirúrgica completa é a opção terapêutica usual. A literatura descreve o CCA como um tumor de baixo potencial de malignidade, porém, diversas recorrências e metástases tem sido relatadas, como verificado no presente estudo.

Palavras Chave:
Carcinoma de Células Acinares
Cancro Oral
Glândula Parótida
Corpos de Psammoma
Tumor de Glândula Salivar
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(Oliveira LR, Soave DF, Costa JPO, Ribeiro-Silva A. Acinic Cell Carcinoma of Parotid Gland: Report of Three Cases and Literature Review. Rev Port Estomatol Med Dent Cir Maxilofac 2010;51:5–11)

Copyright © 2010. Sociedade Portuguesa de Estomatologia e Medicina Dentária
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