gms | German Medical Science

Introduction: Acinic cell carcinoma (ACC) is a rare tumor entity that represents ~10% of all malignant, epithelial salivary gland tumors. Very little information regarding the clinical course of this disease is available. It was the aim of this study to analyse the clinical behaviour of ACC in a greater number of patients.

Methods: 74 patients with a diagnosed ACC (period 1967 – 2004) in the parotid gland (PG) were retrospectively analysed with reference to their clinical presentation, therapy, clinical course and histological subtype of the tumor.

Results: ACC of the PG occurs more frequently in female (73%), predominantly in their 6th decade of life (average age at time of diagnosis 56 years). Histologically, solid ACC was the most common subtype encountered (80%). Papillary-cystic (8%) and microcystic ACC (5%) were found less frequently. Local recurrence (LR) was reported in 21% of all patients, on average 3,5 years after initial diagnosis. Distant metastasis (pulmo) was found in only 2 cases (3%). Further analysis of the group of patients with LR revealed, that in 82% of these cases a latero-facial parotidectomy or tumor-enucleation had been performed. A total or radical parotidectomy was performed in 18% of these cases. 94% of local recurrence was in the group solid- acinary ACC and only 6% with a mixed histological pattern. Only 4% of all patients died due to their disease.

Conclusion: It appears, that in ACC of the parotid gland, local recurrence represents the most important factor for clinical outcome. In this study, we could demonstrate a correlation between the incidence of a LR and the radicality of initial surgical treatment. Therefore, a total parotidectomy even in early tumor stages should be performed in ACC. In this context, the different histological subtypes seem to be secondary in regard to the clinical course of this disease, in particular to the development of LR.