International Journal of Otorhinolaryngology and Head and Neck Surgery | May 2020 | Vol 6 | Issue 5 Page 1013 International Journal of Otorhinolaryngology and Head and Neck Surgery Munjal M et al. Int J Otorhinolaryngol Head Neck Surg. 2020 May;6(5):1013-1015 http://www.ijorl.com pISSN 2454-5929 | eISSN 2454-5937 Case Report Acinic cell carcinoma of ascending ramus mandible: a rare case report Manish Munjal 1 *, Porshia Rishi 1 , Nitika Tuli 1 , Harjinder Singh 1 , Shivam Talwar 1 , Salony Sharma 1 , Shubham Munjal 2 INTRODUCTION Nasse in 1892 described for the first time an uncommon low-grade malignant tumor i.e., acinic cell carcinoma of salivary glands. 1 This acinic cell carcinoma is an unusual, low-grade, malignant salivary gland tumor with approximately almost 90% arising in the parotid gland central ACC of the jaw is an extremely rare neoplasm and exhaustive literature review could reveal only 8 such cases. 1 CASE REPORT A 77 years elderly male presented in the otorhinolaryngology outpatient clinic of Dayananand Medical College and Hospital with an oval swelling on the check on the right side of 5 months duration (Figure 1). Figure 1: Arrow showing the swelling over ascending ramus of mandible. ABSTRACT Acini cell carcinoma are low grade tumors of the salivary glands with a rare occurrence in the axial or appendicular skeleton. The parotid, submandibular and the minor salivary glands are sites of involvement in that order. Painless swelling is the usual presentation with a lytic appearance on radiology and imaging, CT or MRI, FNAC can to some extent differentiate between a benign or malignant lesion thereby dictating the likely extent of excision. On histopathological examination of resected specimens, acinic cell carcinoma shows tumor cells arranged as papillary clusters, acinar pattern and dispersed population with individual tumor cells displaying moderate nuclear pleomorphism, anisonucleosis, round nuclei and moderate amount of ill-defined granular cytoplasm. A unique intraosseous presentation of acinic cell carcinoma, in an elderly male, necessitated a segmental partial mandibulectomy and a comprehensive neck dissection. The tumour area was widely excised from the second premolar region to the coronoid process, and radical neck dissection was performed. Keywords: Acinar cell carcinoma, Mandible, Salivary gland cancer 1 Department of ENT, 2 Department of Anatomy, Dayanand Medical College Ludhiana, Punjab, India Received: 25 February 2020 Revised: 09 April 2020 Accepted: 10 April 2020 *Correspondence: Dr. Manish Munjal, E-mail: manishmunjaldr@yahoo.com Copyright: © the author(s), publisher and licensee Medip Academy. This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. DOI: http://dx.doi.org/10.18203/issn.2454-5929.ijohns20201707