Adenoid cystic carcinoma from diagnosis to oral rehabilitation: case report

Adenoid cystic carcinoma (ACC) is a rare malignant neoplasm of the salivary glands, characterized by sluggish and insidious growth. It is more common in women between 50 and 60 years old and primarily affects the palate, floor of the mouth, and tongue, with high perineural spread. This study aims to report the diagnosis, therapeutic approaches, and oral rehabilitation of a patient with ACC. A 69-year-old female patient presented with a submucosal nodule in the soft palate. The diagnostic hypothesis was salivary gland neoplasm, and an incisional biopsy was performed. Microscopic features revealed mucosa with atrophied para-keratinized epithelium and proliferation of basaloid cell islands in dense connective tissue, with central cystic spaces and rare mitoses. The histopathological analysis revealed an adenoid cystic carcinoma. The patient was referred to an Oncology service and underwent a partial right maxillectomy. Adjuvant treatments were not required. Postoperative imaging exams revealed bone loss and oral-antral communication. The patient complained about difficulty in speaking and eating. A total upper obturator prosthesis was made for the patient’s oral rehabilitation. This case highlights the importance of early diagnosis and a multidisciplinary approach in ACC treatment to reduce complications and improve patients' quality of life.