Multi-modality curative treatment of salivary gland cancer liver metastases with drug-eluting bead chemoembolization, radiofrequency ablation, and surgical resection: a case report

Andreas Karatzas,Ioannis Maroulis,Christina Kalogeropoulou,Konstantinos Katsanos,Evaggelos Tzorakoleftherakis,Dimitris Karnabatidis

doi:10.1186/1752-1947-5-416

Andreas Karatzas, Ioannis Maroulis + Show 4 more

Open Access

https://doi.org/10.1186/1752-1947-5-416

Copy DOI

Abstract

IntroductionLiver metastases are rare in salivary gland tumors and have been reported only once to be the first manifestation of the disease. They are usually treated with surgical resection of the primary tumor and systemic chemotherapy. Drug-eluting bead chemoembolization has an evolving role in the treatment of hepatocellular carcinoma, as well as in the treatment of metastatic disease of the liver. Nevertheless, it has never been used in a patient with salivary gland liver metastases.Case presentationWe report a case of a 51-year-old Caucasian Greek woman who presented to our hospital with liver metastases as the first manifestation of an adenoid cystic carcinoma of the left submandibular gland. The liver lesions were deemed inoperable because of their size and multi-focality and proved resistant to systemic chemotherapy. She was curatively treated with a combination of doxorubicin eluting bead (DC Beads) chemoembolization, intra-operative and percutaneous radiofrequency ablation, and radiofrequency-assisted surgical resection. The patient remained disease-free one year after the surgical resection.ConclusionIn conclusion, this complex case is an example of inoperable liver metastatic disease from the salivary glands that was refractory to systemic chemotherapy but was curatively treated with a combination of locoregional therapies and surgery. A multi-disciplinary approach and the adoption of modern radiological techniques produced good results after conventional therapies failed and there were no other available treatment modalities.

Highlights

Liver metastases are rare in salivary gland tumors and have been reported only once to be the first manifestation of the disease
Case presentation: We report a case of a 51-year-old Caucasian Greek woman who presented to our hospital with liver metastases as the first manifestation of an adenoid cystic carcinoma of the left submandibular gland
The patient remained disease-free one year after the surgical resection. In conclusion, this complex case is an example of inoperable liver metastatic disease from the salivary glands that was refractory to systemic chemotherapy but was curatively treated with a combination of locoregional therapies and surgery

Summary

Introduction

Liver metastases are rare in salivary gland tumors and have been reported only once to be the first manifestation of the disease They are usually treated with surgical resection of the primary tumor and systemic chemotherapy. Drug-eluting bead chemoembolization has an evolving role in the treatment of hepatocellular carcinoma, as well as in the treatment of metastatic disease of the liver It has never been used in a patient with salivary gland liver metastases. Both invasive and minimally invasive surgery, have emerged and offer potential cure to patients who in the past would have been considered candidates only for palliative treatment These treatments include drug-eluting bead (DEB) chemoembolization, percutaneous and intra-operative ablation, and atypical surgical resection techniques. There is no report in the literature on the use of DEB chemoembolization for this type of metastatic tumor

Objectives

Findings

Discussion

Conclusion