Adenoid cystic carcinoma with cystic change of the parotid gland posing a diagnostic challenge: A rare case report

Abstract

Introduction and importance

Salivary gland neoplasms, comprising 2-6.5% of head and neck tumors, primarily arise in the parotid and submandibular glands. Salivary gland cystic lesions can be either neoplastic or non-neoplastic.

Presentation of case

This is a 50-year-old male with a cystic adenoid cystic carcinoma (ACC) in the parotid gland, presenting with a right infraauricular swelling that had progressively enlarged over three years. Fine needle aspiration cytology (FNAC) indicated a benign cystic neoplasm. Histological examination, however, confirmed ACC with cystic changes.

Clinical discussion

A cyst in salivary gland neoplasms can result from degeneration, necrosis, or hemorrhage within the tumor, or when the tumor arises within a non-neoplastic cyst. Differentiating between benign and malignant cystic salivary gland lesions is challenging preoperatively. Accurate preoperative diagnosis is essential to prevent unnecessary surgeries, and techniques such as ultrasound and FNAC are critical in assessing these lesions.

Conclusion

Cystic changes in malignant tumors, particularly ACC, are not frequently reported, underlining the need for increased awareness among clinicians and pathologists. This case highlights the importance of including ACC in the differential diagnosis of cystic salivary gland tumors.