Adenoid Cystic Carcinoma of the Nasopharynx-a Rare Entity: Our Institutional Experience and Therapeutic Approach

Abstract

Adenoid cystic carcinoma of the nasopharynx is a rare, slow growing, and locally aggressive neoplasm. Three cases presented with recurrent epistaxis. Endoscopy-guided biopsy proved the diagnosis of adenoid cystic carcinoma. The location and the extent of the tumor were confirmed on imaging. Surgery followed by radiation therapy was the treatment modality used. All three cases showed good clinical response. The aim is to discuss the surgical approach and review of literature concerning this malignancy.

Keywords: Adenoid cystic carcinoma; Cribriform pattern; Maxillary swing approach; Nasopharynx; Radiation therapy.

Fig. 1

MRI findings suggestive of 3.1 × 2.1 × 3.5 cm sized mass involving the left wall and the adjoining roof of the nasopharynx extending to involve the fossa of Rosenmuller. Laterally, the mass was extending to involve the medial pterygoid muscle (bold arrow), superiorly to the left pterygoid plate, eroding the floor of the middle cranial fossa with extradural extension, and also bulging into the left anterior temporal lobe (white arrow)

Fig. 2

a Pseudostratified ciliated columnar epithelial lined tissue with a submucosal adenoid cystic carcinoma arranged in tubules and cribriform pattern with areas showing invasion of tumor into the cartilaginous tissue (b)