Basal cell adenocarcinoma of the salivary glands. Report of seven cases and review of the literature.

BACKGROUND

Basal cell adenocarcinoma (BCAC) is a rare, recently described salivary gland tumor. The authors report the clinicopathologic features of 7 new cases and compare the results with 65 additional cases in the English literature to comprehend its natural history.

METHODS

Seven cases were retrieved from the surgical pathology files at Presbyterian University Hospital and the Eye and Ear Institute Pavilion in Pittsburgh, Pennsylvania. The cases were accumulated between the years 1985 and 1995. Of these, five were outside consultations.

RESULTS

The 6 women and 1 man ranged in age from 46 to 74 years and presented primarily with a slowly enlarging asymptomatic mass of either the parotid (6 cases) or submandibular gland (1 case). None had facial nerve paresis or cervical lymphadenopathy. Three tumors arose from preexisting basal cell adenomas. Two patients experienced local recurrences and one had distant metastasis. However, all the patients were alive and without known disease at last follow-up (average 30 months).

CONCLUSIONS

Combining the current series with 65 additional cases in the literature indicated that BCAC is a low grade malignant tumor that occurs primarily in the parotid gland (89% of all cases) of older individuals (median 60 years) without gender predilection. Most arise de novo (77%), but occasionally some arise from preexisting basal cell adenomas (23%). Although local recurrences are common (37%), regional lymph node and distant metastasis are rare (8% and 4%, respectively). Local excision with tumor free margins is the treatment of choice.