From the Guidelines
Acinic cell carcinoma is a rare, low-grade malignant tumor that primarily affects the salivary glands, most commonly the parotid gland, and its standard treatment involves surgical removal with clear margins, as recommended by the ASCO guideline 1.
Key Characteristics
- Acinic cell carcinoma originates from the acinic cells responsible for producing digestive enzymes in the salivary glands.
- It typically presents as a slow-growing, painless mass in the affected gland and accounts for approximately 6-8% of all salivary gland malignancies.
- This cancer tends to affect women slightly more than men and can occur at any age, though it's most common in the fifth decade of life.
Treatment Approach
- The treatment involves surgical removal of the tumor with clear margins, sometimes followed by radiation therapy depending on factors like tumor size, grade, and whether it has spread to nearby structures, as supported by the ASCO guideline 1.
- For appropriately located superficial T1 or T2 low-grade salivary gland cancers, partial superficial parotidectomy may be performed, as it allows for complete excision while minimizing the risk to the facial nerve.
Prognosis and Follow-Up
- Acinic cell carcinoma is generally considered low-grade with a favorable prognosis, having an 80-90% five-year survival rate.
- However, the tumor's behavior can be unpredictable, with some cases showing aggressive features despite its typically indolent nature, which necessitates long-term follow-up to monitor for local recurrence or metastasis to regional lymph nodes or distant sites.
From the Research
Definition and Characteristics
- Acinic cell carcinoma (AciCC) is a rare salivary gland malignancy that most commonly arises in the parotid gland 2, 3.
- Characteristics of AciCC are slow growth and a long clinical course 2.
- AciCC is a low-grade malignant salivary neoplasm that constitutes approximately 17% of primary salivary gland malignancies 3.
Diagnosis and Treatment
- Diagnosis is usually confirmed with a fine needle aspiration biopsy, and surgical excision is the main treatment of this malignant neoplasm 3, 4.
- Radical surgery is the best treatment option 5.
- The role of radiotherapy remains controversial, but it may be indicated in some cases, such as to eradicate microscopic residual disease 3, 4.
- Chemotherapy for metastatic AciCC is not well established due to insufficient literature 5.
Prognosis and Survival
- Overall 5-year survival was 97.15%, 10-year survival was 93.81%, and 20-year survival was 89.74% 2.
- Significant differences in survival outcomes were noted for extent of disease, with patients exhibiting distant metastasis displaying the worst long-term prognosis 2.
- High tumor grade was found to be associated with disease progression, and advanced AJCC stage was found to be associated with disease progression 6.