唾液腺に発生した腺様嚢胞癌13例の臨床的ならびに病理組織学的検討

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Thirteen cases of adenoid cystic carcinoma originating from the salivary gland treated in our Department from 1966 to 1987 were studied clinically and pathologically, in an attempt to clarify its correlation between clinical stage, histological grade and prognosis. Both sexes were almost equally represented (7 male and 6 female) and the patients ranged from 39 to 79 years old. The primary sites of the tumors were 7 submandibular gland, 4 palate, 1 parotid gland and 1 buccal mucosa. The cases were classified according to the TNM classification (UICC 1987) and the histological grading (Szanto et al. 1984).<BR>The results were defined as follows:<BR>1) It was suggested that the histological grade and the clinical behavior should be correlated to each other. The prognosis of patients with the tumor of Grade III and Stage IV was most poor. All of these patients died of distant metastasis.<BR>2) In addition to histological grading, primary site, perineural invasion and bone invasion should be considered as other important factors. These findings appeared to be useful in predicting the prognosis.<BR>3) Patients with finding of positive surgical margin had the tendency that local recurrence was generated. Clinically, however, complete removal of the primary tumor was difficult, especially in the minor salivary gland. The planned combination of surgery and irradiation, adjuvant immunochemotherapy and multidisciplinary therapy should be considered.