Adenoid Cystic Carcinoma of the Tongue: A Case Study Highlighting Surgical Management of an Exceptionally Rare Entity

Background: Adenoid cystic carcinoma (ACC) is a rare malignant tumor that accounts for <1 % of head and neck malignancies, with an estimated involvement of the tongue at approximately 3 %.

Case Presentation: This report presents a case of a 42-year-old male with no significant history of tobacco or alcohol use, who developed a painless, progressively enlarging mass on the ventral surface of his tongue over the course of eight months. Initial surgical resection confirmed the diagnosis of ACC, which necessitated a right hemiglossectomy followed by radiotherapy to address potential residual disease.

Discussion: ACC of the tongue presents unique clinical challenges due to its rarity and aggressive nature. The lack of traditional risk factors indicates that ACC can arise in low-risk populations, underscoring the necessity for heightened awareness among healthcare professionals to facilitate early detection. Surgical resection remains the standard treatment; however, achieving negative margins is challenging due to the tumor's infiltrative characteristics, which can lead to local recurrence. Histologically, ACC is classified as a biphasic neoplasm often associated with perineural invasion, and high-grade transformation increases the risk of metastasis. Postoperative radiotherapy is recommended to reduce the risk of recurrence, particularly in cases exhibiting unfavorable histological features. A personalized treatment strategy that takes into account tumor characteristics and patient-specific factors is essential for effective management.

Conclusion: This case underscores the importance of vigilance in identifying symptoms of ACC of the tongue, even in low-risk individuals. It advocates for a multidisciplinary approach that includes surgical intervention and adjuvant radiotherapy to achieve optimal outcomes.