Adenoid cystic carcinoma on the dorsum of the tongue
A 45-year-old-female patient presented with an asymptomatic growth of the tongue, which was perceived just 2 weeks before consultation. The patient reported no significant medical history or any addiction. Laboratory blood studies were requested, which rendered normal results. Chest X-ray was also within normal limits. The intra-oral examination at that time revealed a mass in the dorsum of the tongue with light pain to pressure, without any evidence of cervical lymphadenopathy. The mass was firm, same color as that of the surrounding mucosa and asymptomatic otherwise []. As a pre-operative assessment of the lesion, a fine needle aspiration was done and the smear revealed a salivary neoplasm consisting of well delineated, tightly cohesive clusters of basaloid cells surrounding mucoid, hyaline globules, or clear spaces also forming honeycomb (cribriform) pattern []. At places dense aggregates of monomorphic small cells with uniform round to oval hyperchromatic nuclei and scanty cytoplasm were seen. Smears also showed individual tumor cells with high N: C ratio and nuclear moulding. Fine needle aspiration FNA findings were suggestive of ACC. Subsequently, the patient underwent surgery and the specimen was sent for histopathologic study. Macroscopically, the mass had firm consistency with an irregular form and surface, brown color and measured 2.5 × 1.5 × 1.0 cm. The histopathologic study revealed multiple pseudocystic spaces of variable sizes surrounded by cuboidal cells with scarce cytoplasm and oval nuclei, filled with eosinophilic material and hence was consistent with the diagnosis of ACC []. However, there was no evidence of perineural infiltration on serial sections.