Adenoid Cystic Carcinoma Behaviour — MFDS Part 1 MCQ
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Correct answer: A — Adenoid cystic carcinoma
Adenoid cystic carcinoma is characteristically slow-growing but clinically relentless. It has a marked propensity for perineural invasion, which may cause pain, paraesthesia or nerve dysfunction, and it can recur or metastasise many years after initial treatment. Distant spread is usually haematogenous, particularly to the lungs, whereas regional lymph-node metastasis is relatively uncommon. Mucoepidermoid carcinoma has grade-dependent behaviour rather than this characteristic pattern. Acinic cell carcinoma is often indolent but is not defined by extensive perineural spread. Polymorphous adenocarcinoma can show perineural invasion, but its classical form generally has low metastatic potential. Salivary duct carcinoma is an aggressive, often rapidly progressive tumour with a greater tendency to regional nodal disease.
Reference: International Journal of Oral and Maxillofacial Surgery, "Intraoral adenoid cystic carcinoma: is the presence of perineural invasion associated with the size of the primary tumour, local extension, surgical margins, distant metastases, and outcome?", 2014. https://pubmed.ncbi.nlm.nih.gov/24325947/