Sinonasal Adenoid Cystic Carcinoma
Michelle A. Michel, MD
Key Facts
Terminology
Malignant salivary type of adenocarcinoma
Imaging
Location: Maxillary > nasal cavity
Low grade: Solidly enhancing, well-defined soft tissue mass
High grade: Poorly defined, heterogeneous + bone destruction ± perineural tumor spread (PNTS)
Multiplanar, gadolinium-enhanced MR with fat suppression recommended
Improves detection of PNTS
Top Differential Diagnoses
Sinonasal squamous cell carcinoma
Sinonasal adenocarcinoma (intestinal type)
Esthesioneuroblastoma
Sinonasal undifferentiated carcinoma
Pathology
Not associated with inhalation exposures
3 histologic types
Cribriform (52%); best survival
Tubular (20%)
Solid (29%); worst outcome; higher tendency for PNTS
Most patients present with T4 disease (65%)
Clinical Issues
Sinonasal ACCa accounts for 10-25% of H&N ACCa
Most common SN salivary tumor
Symptoms mimic sinusitisRelated posts:
Stay updated, free articles. Join our Telegram channel
Full access? Get Clinical Tree
