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Adenoid cystic carcinoma of the head and neck

Experience with a group of 54 patients with adenoid cystic carcinoma of the head and neck is presented. The tumors are characterized by a high incidence of local recurrence and ultimate distant metastases after aggressive attempts at surgical excision. Radiation therapy, while not curative, has proved uniformly useful in promoting tumor regression and pain relief in locally advanced and metastatic tumors. Of 41 patients eligible for 5‐year follow‐up, 11 (26.8%) remain free of disease. A clinicopathologic review of the patients in this series indicated they could be divided into 2 groups on the basis of their behavior. A group of 9 patients had a fulminating course with early recurrence, metastasis, and a fatal outcome within 3 years of therapy. A larger group had a prolonged course with survival for many years in spite of recurrences and metastases. A solid histologic pattern with areas of necrosis was notable in many patients in the former group, which may be of value in predicting behavior of a given tumor.