Abordagem Diagnóstica e Terapêutica do Carcinoma Adenoide Cístico: Relato de caso

Abstract

Carcinoma Adenoid Cystic (CAC) is a malignant neoplasm of the salivary glands, being one of the most common salivary gland tumors, representing approximately 6 to 10% of all salivary carcinomas and among head and neck malignancies representing 1%. Clinically, it appears as a swelling or a tolerable nodule, with slow growth, invasive behavior and is more common in adults aged between 50 and 70 years. The most common treatment for this pathology is surgical resection with a safety margin, associated with radiotherapy, however the surgical procedure usually causes important structural deformities. The present work reports the oral rehabilitation of a male patient, 48 years old, diagnosed with CAC in the left maxillary sinus, who underwent partial maxillectomy, at the Hospital de Clínicas de Uberlândia, involving from the region of tooth 14 to the end of the contralateral maxilla. Due to the large oral defect caused by the surgery, lack of supporting tissue, including in the palate area, a rehabilitative intervention was necessary. To improve oral rehabilitation, it was necessary to install four osseointegrated implants in the maxilla, together with the creation of a metal crown on tooth 18, to support an integrated partial denture (PPR) associated with the clip bar system. The patient was irradiated and requested chemotherapy sessions. The treatment proposal aims to reestablish the functions of the stomatognathic system, restoring aesthetics, phonetics and chewing capacity, improving comfort and thus improving the patient's quality of life. After installation, weekly monitoring will be carried out for control.