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Acinic Cell Carcinoma is a rare malignancy accounting for 1 to 6% of all salivary gland tumors and 15% of all malignant tumors in parotid gland. Most acinic cell carcinomas start in the parotid gland. They tend to be slow growing and mainly occur at a younger age than most other salivary gland cancers. They are usually low grade, but how far they have grown into nearby tissue is a better predictor of a patient’s outlook.

The parotid glands are the largest of the salivary glands (the glands which make saliva). They are close to the jawbone, just in front of the ear, one on the right and one on the left. About 7 out of 10 salivary gland tumors start here. Most of these tumors are benign (not cancer), but the parotid glands still are where most malignant (cancerous) salivary gland tumors form.

Acinic Cell Carcinoma was initially thought to be a benign disease. Because of its rarity, initial misunderstanding and unknown character, it has been difficult to study.

Treatment

Acinic cell cancer grows slowly and it is usually possible to operate to remove it. However, if the cancer is advanced when it is found, it may not be possible to completely remove it as there is a risk of damage to vital nerves near the parotid gland.

Radiotherapy often occurs after surgery. Radiotherapy is given to reduce the possibility of the cancer coming back in the same area. These cancers do not usually spread to other parts of the body. However, in some cases, the cancer can spread to the lymph nodes in the neck.

Risk factors

The cause of most salivary gland cancers is unknown, but some factors that may increase a person’s risk of developing salivary gland cancer. Talk with your doctor for more information about your personal risk of cancer and how you may be able to lower your risk.

Age

About two out of every three salivary gland cancers are found in people 55 and older, with an average age of 64.

Radiation exposure

Radiation therapy to the head or neck for another medical reason may increase the risk of developing salivary gland cancer.

Radioactive substance exposure

In some reports, exposure to certain radioactive substances has been linked to an increased risk of salivary gland cancer. Other reports suggest that there has not been enough evidence to support this. Talk with your doctor for more information.

Environmental/occupational exposure

Exposure to sawdust and chemicals used in the leather industry, pesticides, and some industrial solvents may increase the risk of salivary gland cancer in the nose and sinuses.

Early symptoms

Patients usually visit doctors with the symptom of incidental infra-auricular mass. Facial palsy or pain usually may not exist in the first instance. In other studies, the tumor usually appeared as a painless mass in either the superficial or deep lobe of the parotid gland.

Not everyone with the symptoms above will have cancer but see your general practitioner (GP) if you are concerned. 

Diagnosis/diagnosing

Tests and procedures are used to diagnose salivary gland tumors.

Physical exam

Your doctor will feel your jaw, neck and throat for lumps or swelling.

Imaging tests

Imaging tests, such as magnetic resonance imaging (MRI), computerized tomography (CT), positron emission tomography (PET), ultrasound or X-ray, may help your doctor determine the size and location of your salivary gland tumor.

Biopsy

During the biopsy, the doctor inserts a thin needle into the salivary gland to draw out a sample of suspicious cells. Doctors in a lab analyze the sample to determine what types of cells are involved and whether the cells are cancerous.

Prognosis (Certain factors affect the prognosis and treatment options)

Generally Acinic Cell Carcinoma has less aggressive behavior and is considered a low-grade salivary gland carcinoma with low rate of recurrence and metastasis. It is usually thought to carry a good prognosis.

The ten year survival rate is over 65%.

Reference

Some references are to overseas websites. There may be references to drugs and clinical trials that are not available here in Australia.