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Clinical Problem Solving: Pathology
June 2004

Pathology Quiz Case 1—Diagnosis

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Copyright 2004 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.2004

Arch Otolaryngol Head Neck Surg. 2004;130(6):792-793. doi:10.1001/archotol.130.6.792

Acinic cell carcinoma is an uncommon tumor of salivary gland origin. It comprises 5% to 11% of all salivary gland cancers, with salivary gland carcinomas representing 0.3 to 0.9% of all cancers in the United States.1 Acinic cell carcinomas are almost exclusively found in the parotid gland, although rare occurrences in the submandibular and minor salivary glands have been reported. There is a 2:1 female-male predominance, and the highest incidence occurs in the fourth to sixth decades of life. Multicentricity within the parotid gland is noted in 2% to 5% of cases. Acinic cell carcinoma ranks second, after Warthin tumor, for bilaterality among parotid neoplasms, and it can have a similar intranodal (parotid and periparotid) origin. It ranks as the third most common epithelial malignancy of the salivary glands in adults and, according to Batsakis et al,2 is second only to mucoepidermoid carcinoma among malignancies of the parotid gland in children aged 12 years or younger. Involvement of the deep lobe of the parotid glands or presentation as a parapharyngeal space mass is extremely rare.3

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