CENTRAL ADENOID CYSTIC CARCINOMA OF THE MANDIBLE WITH ODONTOGENIC FEATURES: REPORT OF A CASE

Background. Primary intraosseous salivary-type adenocarcinomas are rare neoplasms of uncertain histogenesis. The prevailing theories suggest origin from heterotopic salivary glands, odontogenic rests, or cystic epithelium. Methods. A case of central adenoid cystic carcinoma is reported in a 53-year-old woman who presented with a painless swelling in the anterior segment of her lower jaw. Radiographic examination confirmed the presence of an expansile, radiolucent lesion within the mandible with a multilocular appearance, On light microscopy analysis, areas showing cribriform and tubular growth patterns; admixed cysts, some of which were characterized by the presence of localized plaque-like thickenings of their epithelial linings; and the formation of aberrant dental hard tissue were observed. Results, The radiographic and histomorphologic findings highlight the potential misdiagnosis of this rare tumor. The findings also draw attention to an embryologic histogenetic concept for some central salivary neoplasms. Conclusion. The divergent salivary and odontogenic differentiation evident in this tumor signifies the pluripotential nature of derivatives of oral ectoderm. (C) 2009 Wiley Periodicals, Inc. Head Neck 31: 975-980, 2009