Adenosquamous carcinoma of the head and neck: report of 20 cases and review of the literature

Purpose. To assess the clinical profile and prognostic factors in patients with adenosquamous carcinoma (ASC) of the head and neck treated by surgery and/or radiation therapy with or without chemotherapy. Methods. Data from 20 patients with stage I-II (n ¼ 4), III (n ¼ 5), or IVA (n ¼ 11) head and neck ASC, treated between 1989 and 2010 were collected in a retrospective multicenter Rare Cancer Network study. Surgery was performed in 16 patients. Seventeen patients received combined modality treatment. Results. After a median follow-up of 15.5 months, 12 patients recurred. The 3-year and median overall survival, disease-free survival (DFS), and loco-regional control were 52% and 39 months, 32% and 12 months, and 47% and 33 months respectively. In multivariate analysis, DFS was negatively influenced by the presence of extracapsular extension and advanced stage. Conclusion. Overall prognosis of locoregionallyadvanced ASC remains poor. However, early stage ASC patients managedwith combined modality treatment may have prolonged DFS. (Oral Surg Oral Med Oral Pathol Oral Radiol 2013;116:313-320) Adenosquamous carcinoma (ASC) of the head and neck is a rare malignancy, with fewer than 100 cases reported in the English literature. This entity was first described in 1968 by Gerughty et al. in a series of 10 patients, where it was shown to be extremely aggressive, with 80% of the patients developing metastases. 1 For many years, it has been considered to be the same entity as salivary mucoepidermoid carcinoma (MEC). However, in 1984, Evans suggested that ASC should be considered as a distinctive neoplasm given its worse prognosis as compared to MEC, even high-grade. 2 In fact, metastasis and death from MEC are relatively uncommon. ASC is now defined in the World Health Organization (WHO) classification of tumors of the upper respiratory tract and ear as a malignant tumor with histological features of both adenocarcinoma and squamous cell carcinoma (SCC). 3 The SCC component