Radicality and QOL of Adenoid Cystic Carcinoma invading the Upper Jaw intraosseously with Lung Metastasis

• Published in: Journal of Japan Society for Oral Tumors Vol. 7; no. 2; pp. 37 - 44
• Main Authors: Shimizu, Masatsugu, Yanagisawa, Shigetaka, Kawano, Kenji, Ono, Kei-ichiro, Matsushima, Rintaro
• Format: Journal Article
• Language: Japanese
• Published: Japanese Society of Oral Oncology 1995
• Subjects: adenoid cystic carcinoma; intraosseous upper jaw invasion; lung metastasis; palatal mucosa; QOL
• ISSN: 0915-5988; 1884-4995
• DOI: 10.5843/jsot.7.37

A case of a 34-year-old female with adenoid cystic carcinoma, originated from the left palatal mucosa, was treated in our department and reported. Since she consulted our clinic at first with a complaint of swelling of the left buccal and palatal gum with a letter of a doctor, who asked us to remove 27 because of dental infection, anti-inflammatory treatment was carried out and the symptom disappeared, except a slight swelling of the left palate. Then six years later, she came to our department again with a complaint of ulcer formation in the left palatal region. The histological diagnosis of adenoid cystic carcinoma was decided through biopsy, and the X-ray examination revealed the multiple lung metastasis. So the case was classified as T2N0M1 by UICC. The treatment against the tumor was carried out through the trimodal therapy firstly but without apparent effect. So the total excision of the primary tumor with superhemimaxillectomy was performed, and then plastic surgery with DP-flap was performed Because of the slow-growing but inoperable lung metastasis, the primary tumor excision was finished resulting in tumor-free findings macroscopically, considering the informed consent and QOL of the female patient with an age of 40 years. About one year later, a composite skin graft on the left upper red lip was performed successfully, from cosmetic and functional view point. Furthermore, a maxillary resection prosthesis was set on the left upper jaw, which brought her a better QOL on function and appearance. She has received an ambulatory examination periodically, taken immunological and antitumor medicament and returned to the social life for 3 years and 6 months.