Acinic cell carcinoma of the parotid gland: from pathogenesis to management: a literature review
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REVIEW ARTICLE
Acinic cell carcinoma of the parotid gland: from pathogenesis to management: a literature review M. Cavaliere1 · P. De Luca2 · A. Scarpa2 · L. Savignano1 · C. Cassandro3 · E. Cassandro2 · M. Iemma1 Received: 25 February 2020 / Accepted: 18 April 2020 © Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Purpose Acinic cell carcinoma (ACCs) is uncommon malignant epithelial neoplasm of the salivary glands; the most common presentation is a well-defined painless solid mass. Diagnosis of ACCs is frequently complicated, due to its similarity with benign tumors. Methods A review of the literature available on ACCs was carried out. Studies were sourced from PubMed with searching of relevant headings and sub-headings and cross-referencing. Results There are no clear characteristics of ACCs found on CT, MRI and ultrasound imaging. The management of the ACC, a rare malignancy of the parotid gland, is often difficult and controversial. Radical surgery is the best treatment option. The role of radiotherapy remains controversial: the precise indications and oncologic effects of adjuvant radiotherapy in ACC of the parotid gland are not well known. There is insufficient literature regarding the chemotherapy for metastatic ACC. Conclusion Knowledge about ACC, a rare malignancy of parotid gland, has changed over the past few decades. More clinical randomized works would be needed, both to assess the real effectiveness of radio and chemotherapy and to have an unanimous consensus about their indications. Keywords Acinic cell carcinoma · Parotid gland · Lateral skull base neoplasm
Definition According to the World Health Organisation (WHO) histological classification of salivary gland tumors, Acinic Cell Carcinoma (ACCs) is ‘‘a malignant epithelial neoplasm of salivary glands in which at least some of the neoplastic cells demonstrate serous acinar cell differentiation, which is characterized by cytoplasmic zymogen secretory granules. Salivary ductal cells are also a component of this neoplasm”.
M. Cavaliere and P. De Luca equally contributed to this work. * P. De Luca [email protected] 1
Department of Otorhinolaryngology, University Hospital “San Giovanni di Dio e Ruggi d’Aragona”, Salerno, Italy
Department of Medicine, Surgery and Dentistry, Scuola Medica Salernitana, University of Salerno, Via Salvator Allende 43, Salerno, Italy
2
3
Surgical Sciences Department, University of Turin, Turin, Italy
It typically arises in the parotid gland (85% of cases) [1] and comprises 6–16% of all malignant tumors arising in major salivary glands, and 7% of those of parotid gland [2] (from 3 to 11% of all adult parotid cancer) [3, 4]. Firstly classified as a “benign adenoma” (“or acinic cell tumor”) by Goodwin et al. [5] in 1890, Buxton et al. [6] recognized it as a malignant tumor in 1953, and recently WHO re-classified ACC as malignant carcinoma [7]. Although it has been considered for long time as a neoplasm with a good prognosis, today, we should consider it a malignancy with unpredictable c
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