LXIII Malignancy of Acinic Cell Carcinoma

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Abstract
Histologicaliy, acinic cell carcinoma is as highly characteristic type of tumor; in a histological re-examination of 2,102 parotid tumors, it was identified in 63 cases (about 3%). In 3 of the 63 patients (4.8%), both parotid glands were involved. This is remarkable, since, with the exception of papillary cystadenolymphoma, bilateral parotid tumors have seldom been demonstrated. In one of these cases, there was a 15-yr. asymptomatic interval between the appearance of acinic cell carcinoma of the right and left parotid. Shortly after parotidectomy for the 2nd tumor, generalized subcutaneous metastases developed. Spontaneous paralysis of the facial nerve was present in only 2 cases. This incidence is low in comparison to that in other malignant salivary gland tumors. The influence of the time factor on the determinate survival rate is evident in a follow-up study. Thus, this survival rate fell from 90% after 5 yr. to 50% after 25 yr. This shows that the prognosis quoad vitam is considerably poorer than previously inferred from short-term follow-up studies. The importance of radical surgery in acinic cell carcinoma is stressed. It is recommended that local surgical Intervention should be complemented by neck dissection, since metastasis to the cervical lymph nodes has proved to be less rare than was previously believed.

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