SALIVARY GLANDS;

CLINICAL & HISTOPATHOLOGICAL SPECTRUM OF ADENOID CYSTIC CARCINOMA & MUCOEPIDERMOID CARCINOMAS REPORTED AT TERTIARY CARE HOSPITALS IN LAHORE

Abstract

Objectives: Adenoid cystic carcinoma (AdCC) and mucoepidermoid carcinoma
(MEC) are the commonest salivary gland malignancies in Pakistan constituting almost 75%
of all malignant salivary gland tumours. The objective of this study was explore the clinical &
morphological spectrum of these tumours in local population and to grade them w.r.t. modern
grading criteria. Study Design: Descriptive study. Setting: Department of Morbid Anatomy and
Histopathology/ Oral Pathology, University of Health Sciences Lahore, Pakistan. Period: Jan.
2014 to Sep. 2015. Method: Paraffin embedded blocks and detailed clinical data of 20 cases
each of adenoid cystic carcinoma and mucoepidermoid carcinoma reported at local tertiary
care hospitals. The histologic diagnosis was made on Hematoxylin and Eosin staining. The
tumours were graded into grades I, II & III according to the most recent grading criteria. AdCC
was studied with respect to its morphological patterns (tubular, cribriform and solid) while MEC
was studied with special concern to the cell types seen in it (mucous, intermediate, squamous
and clear cells). Results: The most frequently observed age group for the patients of AdCC
was the 5th (45%) decade with mean age of 41.50±12.224 years and a female predilection of
1.5:1. Minor salivary glands were the commonest site involved (80%) of which palate was most
frequently affected (37.5%) followed by maxilla (25%). Grade I (75%) was most frequently noted
grade in AdCC. Cribriform pattern (60%) was the most frequently encountered predominant
histological pattern followed by equal distribution of tubular and solid Patterns (20% each).
MEC affected most patients in 3rd (30%) decade with mean age of and 32.35±13.674 years
and male predilection (60%). Parotid gland (70%) was the commonest site involved followed
by maxilla (10%). Histologically, grade III (40%) was most frequently noted followed by grade
I (35%) and grade II (25%). Squamous cells (65%) were the predominant cell type in most
cases followed by mucous cells in (35%) cases. Conclusion: Adenoid cystic carcinoma and
mucoepidermoid carcinoma both affect a younger age group in our population with a female
(1.5:1) and male (1:1.5) predilection respectively. The most favoured site for AdCC and MEC is
palate and parotid gland respectively. Grade I AdCC and cribriform pattern are the commonest
grade and pattern encountered in this study. On the other hand, high grade (Grade III) MEC
is the most regularly encountered grade in MEC. So, proper grading and staging along with
meticulous surgical approach is needed to improve the life expectancy in these patients.