Adenoid cystic carcinoma of the salivary gland

Last revised by Henry Knipe on 18 Oct 2024

Adenoid cystic carcinomas of the salivary gland are the second most common malignancy involving the minor salivary glands, behind mucoepidermoid carcinoma. They are the second most common malignancy involving the parotid gland.

Adenoid cystic carcinomas arise more commonly in the minor salivary glands (~55%) than in the major salivary glands. They are the most common sinonasal tumours of salivary origin. They are locally aggressive with a propensity for perineural spread 5

Generally, a distinction is made radiologically between low-grade and high-grade adenoid cystic carcinomas. Low-grade tumours tend to be well-defined, in contradistinction to high-grade tumours, which appear infiltrative. However, both subtypes are usually homogeneously enhancing after contrast administration.

Adenoid cystic carcinomas are frequently associated with perineural spread (via cranial nerve VII), which is well appreciated on MRI.

  • T1: hypo- to isointense

  • T2: slightly hyperintense, with higher grades being markedly hypointense 6

  • T1 C+ (Gd): homogeneous enhancement

Cases and figures

  • Figure 1: salivary gland tumour frequency
  • Case 1
  • Case 2

Imaging differential diagnosis

  • Mucoepidermoid carcinoma
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