A 58-year-old woman presents to her ENT specialist with a mass in her parotid gland. A biopsy is performed, and the pathology report indicates a malignant tumor with evidence of perineural invasion.
Perineural invasion is common in:
A. Pleomorphic adenoma
B. Acinic cell carcinoma
C. Mucoepidermoid carcinoma
D. Adenoid cystic carcinoma
Answer:
The Correct Answer is: D. Adenoid cystic carcinoma
Explanation:
Adenoid cystic carcinoma (D):
– Adenoid cystic carcinoma is a malignant salivary gland tumor known for its propensity for perineural invasion. This characteristic feature involves the cancer cells spreading along nerve sheaths, which can cause significant pain and other nerve-related symptoms.
– Perineural invasion is a hallmark of adenoid cystic carcinoma and contributes to its tendency for local recurrence and distant metastasis, despite often having a slow clinical course.
Explanation of Incorrect Options:
Pleomorphic adenoma (A):
– Pleomorphic adenoma is the most common benign salivary gland tumor. It does not typically exhibit perineural invasion. It is generally non-invasive but can recur if not completely excised.
Acinic cell carcinoma (B):
– Acinic cell carcinoma is a malignant salivary gland tumor that is usually less aggressive than adenoid cystic carcinoma and mucoepidermoid carcinoma. While it can recur and metastasize, perineural invasion is less common.
Mucoepidermoid carcinoma (C):
– Mucoepidermoid carcinoma is a malignant salivary gland tumor that can show perineural invasion, but it is not as commonly associated with this feature as adenoid cystic carcinoma. The presence of perineural invasion in mucoepidermoid carcinoma indicates a more aggressive behavior.
In conclusion, perineural invasion is common in adenoid cystic carcinoma, making option D the correct answer.