American Board of Surgery Qualifying Exam (ABS QE) Practice Test

What is the management approach for adenoid cystic carcinoma?

1. Radiation therapy only

2. Superficial parotidectomy

3. Total parotidectomy and post-operative radiation therapy

4. Chemotherapy

The correct answer is: Total parotidectomy and post-operative radiation therapy

The management approach for adenoid cystic carcinoma typically involves a combination of surgical and possibly adjuvant treatment due to the tumor's aggressive nature and the high potential for local recurrence and metastasis. In this case, total parotidectomy is a common surgical approach for adenoid cystic carcinoma arising in the parotid gland, as it aims to achieve complete tumor resection. This is crucial because adenoid cystic carcinoma can invade surrounding tissues and has a propensity to spread along nerves, making complete excision important for local control. Post-operative radiation therapy is often recommended to manage residual microscopic disease and reduce the risk of local recurrence, especially given the tumor's tendency to metastasize despite initial treatment. The use of radiation therapy aligns with the need to enhance the effectiveness of the surgical intervention and address any undetected cancer cells that remain after surgery. While radiation therapy alone can be utilized in certain scenarios, particularly in cases where surgery is not feasible, it is generally not considered sufficient as a standalone treatment for this type of carcinoma. Instead, a combined approach of surgery followed by radiation therapy is more effective, aligning with best practices for managing adenoid cystic carcinoma. Chemotherapy is not typically a front-line treatment for this type of cancer