In a group of 245 cases of primary carcinoma of the esophagus the authors found three cases of adenoid cystic carcinoma (ACC). Clinical and pathologic data of those patients (one female and two male; age range, 49-74 years) were analyzed. Tumors were localized in the middle third of the esophagus. One patient lived 15 months after surgery. Another is a case of early ACC who has been living 4.5 years after surgery and is without specific symptoms. The third patient had not had surgery and died 13 months after the onset of dysphagia. An autopsy showed only a locally invasive tumor growing into the surroundings of the esophagus, and regional lymph node metastases without distant parenchymal metastases. These findings support pathologic and biologic similarities between ACC of the esophagus and ACC of the salivary glands. There are synchronous tumors of the esophagus and the vital localization which makes the prognosis of ACC of the esophagus worse than ACC of the salivary glands. Cancer 679159-2164,1991.
DENOID CYSTIC CARCINOMA (ACC) is usually found
A in the salivary glands of the head and neck.',' A rare localization is in the esophagus where most of the authors report a single case or a small series of case^.^-"
The first case of ACC of the esophagus was reported by Gregg and StamlerI7 who described "basal cell carcinoma with adenoid cystic pattern."
In English literature 49 cases of ACC of the esophagus have been published until now. Enterline and Thompson" point out that there are too few cases for a definite picture of biological nature of this tumor, especially because of the small number of data on clinical follow-up. The autopsy analyses are also very scarce. Analysis of the most of the published cases was done by Pet~rsson.~ Many authors point out aggressive behavior and intensive widespread metastasizing of ACC of the esophagus in comparison with ACC of the salivary glands. This is explained by greater polymorphism, great mitotic activity, From the