ISSN : 2146-3123
E-ISSN : 2146-3131

High-Grade Transformation of Adenoid Cystic Carcinoma Delineated with a Fibrous Rim: A Case Report
Hamide Sayar 1, Sevgi Bakariş 1, Sülen Sarıoğlu 2, İlhami Yıldırım 3, Hüseyin Öztarakçı 4
1Department of Pathology, Kahramanmaraş Sütçü İmam University Faculty of Medicine, Kahramanmaraş, Turkey
2Department of Pathology, Dokuz Eylül University Faculty of Medicine, İzmir, Turkey
3Department of Otolaryngology, Kahramanmaraş Sütçü İmam University Faculty of Medicine, Kahramanmaraş, Turkey
4Department of Otolaryngology, Necip Fazıl Şehir State Hospital, Kahramanmaraş, Turkey
DOI : 10.5152/balkanmedj.2013.7220
Pages : 333-336


Background: High-grade transformation or dedifferentiation in carcinoma is progression of a low-grade malignant neoplasm to a high-grade carcinoma or poorly differentiated adenocarcinoma. This is rarely observed in adenoid cystic carcinoma of the salivary glands. 

Case Report: A 39 year-old woman presented with a painless mass at the left submandibulary region that had been growing slowly for 5 years. Submandibulary mass resection revealed a mass with peripheral adenoid cystic carcinoma and a central high-grade tumor delineated with a fibrous rim, raising the possibility of a hybrid or composite carcinoma, requiring differential diagnosis depending upon morphology and immunohistochemistry findings. The final histopathological diagnosis was high-grade transformation of adenoid cystic carcinoma. After surgical therapy, the patient was irradiated to the neck and submandibulary region. No sign of tumor recurrence has been evident for 36 months.

Conclusion: This present case seems to be another rare case with high-grade transformation of adenoid cystic carcinoma and the fibrous rim may be a histopathological feature of such cases, which should be kept in mind.

Keywords : Adenoid cystic carcinoma, submandibulary gland, dedifferentiation, high-grade transformation.
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