A 42-year-old woman presents with a slowly enlarging ulcerated swelling of the hard palate and numbness over the left upper alveolus and lip. Biopsy shows cribriform nests of small basaloid cells within a myxoid stroma. Which pattern of behaviour is most characteristic of this tumour?

• A Predictable cure with enucleation alone
• B Early and extensive cervical lymph node metastasis
• C Rapidly fatal course within months despite treatment
• D Perineural spread with late haematogenous metastasis to lung and bone ✓

Explanation

Adenoid cystic carcinoma is the commonest malignant tumour of minor salivary glands such as the hard palate, and it characteristically spreads along nerves, explaining the numbness through palatine branches of the maxillary nerve. Frozen sections of nerve margins guide resection. It disseminates late by blood to lung and bone, while nodal spread is distinctly uncommon, ruling out option B as the defining feature.

Reference: Robbins and Cotran Pathologic Basis of Disease, 10th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.