Nasopharyngeal Adenoid Cystic Carcinoma Case Report and Review

Adenoid Cystic Carcinoma (ACC) is a rare slow-growing salivary gland neoplasm with malignant behavior and a high recurrence rate. It originates from salivary glands. Nasopharyngeal located ACC (NACC) is a very rare malignancy due to its location with specific biological characteristics. There is no consensus at present regarding clinical characteristics, treatment approaches and prognostic factors. Our aim is to review the literature related to this topic in light of our case about this rare malignancy. A 36-year-old female at 35 weeks pregnancy was admitted to the Gynecology and Obstetrics service for hypertension. The patient had a history of a nasopharyngeal carcinoma for which she underwent radiotherapy 11 years ago. A neurology and eye consultation required for ptosis of her left eye An orbito-cranial MR demonstrated expansive mass lesions that were initially thought to be mucoceles filling the nasal cavity, left maxillary and sphenoid sinuses. A biopsy of the lesions was reported as ‘adenoid cystic carcinoma’. The patient died 6 months later. Our case is special due to the patient’s arrival with cranial nerve invasion, slow progression, expansive growth pattern, misdiagnosis as a mucocele clinically and radiographically. Because of its high rate of cranial nerve invasion, this neoplasm must be considered in the differential diagnosis. In sinonasal mass lesions with nasal obstructive symptoms, the possibility of malignancy must be eliminated. Despite the fact that papillomas spread expansively, a biopsy must be obtained for prompt diagnosis and treatment. Additionally patients diagnosed with nasopharyngeal carcinoma, even if they are treated and cured, must be called for control in routine intervals because of the malignant behavior and high recurrence rate.