Adenoid cystic carcinoma(ACC) is an uncommon tumor of the head and neck. It is one of the most common malignant tumor of the salivary glands. Although ACC has clear pathologic features, it can be diagnosed as a benign lesion in terms of cytological and radiologic aspects. In this paper, we report a rare case of ACCACC on tongue that is diagnosed as ACC but appears as a benign lesion in cytological and radiologic views.

Lysyl oxidase (LOX) family, the copper dependent amine oxidase, oxidizes lysine residues in extracellular collagen and elastin. LOX increases the strength of the extracellular matrix and plays an important role in tumor development and metastasis. It has been reported that increased LOX protein and RNA are found in head and neck squamous cell carcinoma. Moreover some studies regarded LOX as a prognostic marker of oral and oropharyngeal squamous cell carcinoma. However there has not been any report on LOX expression of salivary gland tumors. Here, we investigated LOX expression in mucoepidermoid carcinoma (MEC) and adenoid cystic carcinoma (ACC) of salivary gland and compare it to those of pleomorphic adenoma (PA). We evaluated LOX expression in eighteen MEC, eighteen ACC and twenty PA cases by immunohistochemical examination. Whereas PA showed relatively low density of LOX expression, ACC revealed more cases that showing high staining intensities for LOX. Significantly increased LOX expression was found in the cases of ACC when compared to those of PA (P = 0.010).

Adenoid cystic carcinoma(ACC) is one of the most common malignant tumors of minor salivary glands and can also arise in a variety of sites in the head and neck including the major salivary glands, the esophagus, the lacrimal glands. ACC shows slow but relentless growth, so it shows long-term recurrence. The various reports about prognostic factors which influence the recurrence pattern are introduced but the reports about prognostic factors are rare in Korean adenoid cystic carcinoma patients. We examined 40 ACC patients who finally diagnosed at Department of Oral Pathology, Seoul National University Dental Hospital. Clinicopathologic and immunohistochemical features were reviewed and factors correlated with recurrence and survival were analyzed. The 5-year survival rate of T3,T4 stage was 31.2%, while that of the T1,T2 stage was 88.2%, and the difference 5-year survival and T stage was statistically significant. The rate of local recurrence was 20% and the rate of distant metastasis was 27.5%. Mean recurrence time were 4.8 years and 5.2 years. There was no significant difference between age, sex, T stage, TNM stage, histologic type and recurrence. But the high T stage and the solid type recurred more frequently. There was no significant difference between recurrence rate, 5-year survival rate and Ki-67, MVD expression. But the higher expression of Ki-67, MVD show the higher recurrence rate and the lower 5-year survival rate