AB245. SOH25_AB_159. Adenoid cystic carcinoma on the upper lip: a rare case report

Background: Adenoid cystic carcinoma (ACC) is a rare, slow growing and insidious malignancy of glandular and ductal cells. ACC only accounts for 1% of head and neck malignancies. It manifests between 6th and 7th decades of life. Surgical excision with required radiotherapy, chemotherapy or combined therapy are possible treatment choice. In this case, a 64-year-old male was diagnosed with an ACC of the upper lip, that clinically presented as a lump with no malignant features. Only 20 such cases exist in the literature. Investigations were carried out with magnetic resonance imaging (MRI) base of skull to rule out any neurological involvement or metastasis. A wide local excision of the lesion was done under general anaesthetic and the lip reconstructed with a Karapandzic flap. Post op healing was uneventful. He then subsequently underwent radiotherapy. A regular follow-up pattern was devised and adhered to helping monitor the site.

Methods: Extensive search of PubMed for keyword adenoid cystic carcinoma AND lip OR upper lip. Also a search on the PubMed database for any recurrence of ACC post treatment of any site. Returning only 10 cases reported to date of ACC on the lip across the globe.

Results: A total of 10 cases of upper lip ACC were compared to the progress of the case seen in University Hospital Limerick and the method from clinical presentation, investigations, treatment and follow up are described and recorded with desirable outcome for the patient.

Conclusions: ACC is slow growing, rare malignancy that often is diagnosed clinically as a benign minor salivary gland tumor. This is why histopathological correlation is needed to confirm/change the diagnosis and computed tomography (CT)/MRI scan for thorough investigations of any metastatic disease progression prior to any treatment planning.

Keywords: Adenoid cystic carcinoma (ACC); radiotherapy; recurrence; upper lip lump