Treatment of Recurrent or Metastatic Adenoid Cystic Carcinoma of the Submandibular Gland
Clinical Scenario
Adenoid cystic carcinoma (AdCC) is the most common malignant tumour type of the submandibular gland. In the recurrent or metastatic setting, disease is generally characterised by multiple locoregional recurrences, with distant metastases — most frequently to the lungs — occurring in approximately half of cases.
Management Approach
For patients whose disease has spread only to the lungs with no local recurrence, active surveillance is among the strategies employed — though the specific criteria that govern when a more interventional approach should be considered are outlined in the full structured protocol.
References
DOI: 10.1016/j.esmoop.2022.100602
- The most common submandibular gland malignant tumour type is AdCC.
- Metastatic AdCC is generally characterised by multiple locoregional recurrences accompanied by distant metastases in about half of cases.
- In case of only lung metastases without local recurrence, a watch-and-wait strategy is recommended until complaints or rapid growth (local treatment of lung metastases could be considered in selected cases) [III, B].
- Lung metastasectomy should be considered in patients without other R/M tumour deposits, provided that a complete surgical resection is feasible and disease-free interval from primary diagnosis is >36 months.
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