ADENOID CYSTIC CARCINOMA: A CASE REPORT

Abstract

Adenoid cystic carcinoma (ACC) is an uncommon malignant glandular neoplasm characterized by infiltrative growth, marked perineural invasion and a tendency toward late hematogenous dissemination, particularly to the lungs. Because of its peculiar biological behavior, the tumor may remain indolent for long periods, which hinders early diagnosis and demands prolonged clinical follow-up. This paper describes the clinical course of a male patient, 23 years old at the time of diagnosis, who presented an expansive lesion in the right hemimaxilla, initially mistaken for an odontogenic condition. Complementary investigation, including computed tomography, magnetic resonance imaging and histopathological analysis, confirmed ACC with extensive bone involvement and invasion of adjacent structures. Therapeutic management included total maxillectomy and adjuvant radiotherapy. After approximately three years of clinical stability, a single pulmonary nodule consistent with distant metastasis was identified and treated exclusively with radiotherapy. The patient is currently asymptomatic, under multiprofessional follow-up and reports good quality of life. This report highlights the importance of clinical suspicion when facing maxillary lesions with atypical evolution in young patients, and reinforces the need for long-term surveillance and an interdisciplinary approach for patients affected by salivary gland neoplasms.