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acinic cell carcinomaBreast
An extremely rare carcinoma that is morphologically identical to the same-named tumours of the salivary glands. There is little known about their behaviour, but they do metastasise to regional lymph nodes and may be fatal.
Microglandular adenosis, apocrine carcinoma.
A usually low-grade, slowly growing salivary (80% are parotid) gland carcinoma with serous acinar cell differentiation. It comprises 1% to 6% of salivary gland tumours, and 10% to 17% of all salivary gland malignancies. In some series it is more common in females, in others, men; it peaks in the 5th decade; 3% are bilateral.
Radiation exposure, familial predisposition, wood dust inhalation.
Outcomes are worse with larger tumours, incomplete excision, deep lobe involvement and MIB proliferation index of > 10%.
5-year survival, 90%; 20-year-survival, 55%; 12–35% recur, 8% metastasise.
Pain at presentation, fixation of tissue to other structures, gross invasion, focal necrosis, perineural invasion, histologic features: desmoplasia, atypia/pleomorphism, increased mitotic activity. Prognosis is better if the tumour nodules are well-circumscribed, microcystic and have lymphoid follicles.
Usually wide local excision suffices; complete first-time surgical excision is critical to cure.
Adenocarcinoma in which the cells are in the shape of alveoli. Synonym: alveolar adenocarcinoma
See also: adenocarcinoma