Adenoid cystic carcinoma of the mobile tongue: A rare case
A 36-year-old female patient had complained of a swelling in the right side of the tongue since 1 month, which had started spontaneously and then showed a rapid increase in size. The patient developed a dull and intermittent pain 2 days after the swelling had started. She had difficulty with speech and swallowing. Extra-orally, a single submandibular lymph node on the right side was palpable, tender, soft in consistency and freely movable. Intra-oral examination revealed a diffuse swelling on the right side involving the dorsum, right lateral border [] and ventral surface of the tongue []. It extended from the tip of the tongue to 1 cm beyond the anterior two-thirds. Medially, it crossed the midline by 2 cm. The overlying mucosa was normal and the surface of the swelling was smooth; margins were ill-defined. There were no ulcerations or sinus openings. On palpation, the swelling was tender and firm in consistency and moved along with the tongue movements.\nA provisional diagnosis of malignant soft tissue neoplasm from the muscles of the tongue or minor salivary glands was made.\nMagnetic resonance imaging (MRI) neck plain revealed a well-defined T1 hypo-STIR [] hyperintense lesion involving the anterior half of the tongue with displacement of the intrinsic muscles superiorly and to the left side. The lesion showed small GRE/T2 [] hypointense foci within the lesion.\nExcision biopsy was done under general anesthesia and the histopathological findings revealed isomorphic basaloid tumor cells with a cribriform pattern and numerous cystic spaces []. There was compressed dense connective tissue in the periphery that was infiltrated by tumor islands. Few areas showed perineural invasion. Correlating the clinical, MRI and histopathological findings, a final diagnosis of adenoid cystic carcinoma of mobile tongue was made.