A 55-year-old woman presents with a 3 cm firm mass in the right submandibular gland. FNAC confirms adenoid cystic carcinoma. Which of the following is the most characteristic biological behavior of this tumor?

• A Early hematogenous spread to bone and lung
• B Excellent 5-year survival exceeding 90%
• C High rate of cervical lymph node metastasis at presentation
• D Propensity for perineural invasion and skip lesions ✓

Explanation

Adenoid cystic carcinoma is notorious for perineural invasion with skip lesions, making adequate surgical margins difficult and contributing to local recurrence. Hematogenous spread occurs but is not its most defining feature. Nodal metastasis is relatively uncommon compared to other salivary malignancies. Long-term prognosis is poor due to late recurrence.

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.