Adenoid cystic carcinoma of the tongue: A case study highlighting surgical management of an exceptionally rare entity

Abstract

Background

Adenoid cystic carcinoma (ACC) is a rare malignant tumor that accounts for <1 % of head and neck malignancies, with an estimated involvement of the tongue at approximately 3 %.

Case presentation

This report presents a case of a 42-year-old male with no significant history of tobacco or alcohol use, who developed a painless, progressively enlarging mass on the ventral surface of his tongue over the course of eight months. Initial surgical resection confirmed the diagnosis of ACC, which necessitated a right hemiglossectomy followed by radiotherapy to address potential residual disease.

Discussion

ACC of the tongue presents unique clinical challenges due to its rarity and aggressive nature. The lack of traditional risk factors indicates that ACC can arise in low-risk populations, underscoring the necessity for heightened awareness among healthcare professionals to facilitate early detection. Surgical resection remains the standard treatment; however, achieving negative margins is challenging due to the tumor's infiltrative characteristics, which can lead to local recurrence. Histologically, ACC is classified as a biphasic neoplasm often associated with perineural invasion, and high-grade transformation increases the risk of metastasis. Postoperative radiotherapy is recommended to reduce the risk of recurrence, particularly in cases exhibiting unfavorable histological features. A personalized treatment strategy that takes into account tumor characteristics and patient-specific factors is essential for effective management.

Conclusion

This case underscores the importance of vigilance in identifying symptoms of ACC of the tongue, even in low-risk individuals. It advocates for a multidisciplinary approach that includes surgical intervention and adjuvant radiotherapy to achieve optimal outcomes.