Abstract
Salivary duct carcinoma (SDC) is a rare and aggressive parotid malignancy that most commonly affects males in the fifth and sixth decades of life. Histopathology specimens obtained from SDC patients demonstrate a resemblance to ductal carcinoma of the breast. Therefore, to distinguish SDC from breast ductal carcinoma, several immunohistochemical markers exist that may enable surgeons to make an accurate diagnosis. In this study, the case of a 54-year-old male with salivary duct carcinoma of the right parotid gland is presented. The results of the present case study revealed that the SDC sample was positive for the expression of human epidermal growth factor 2 (Her-2), cytokeratin (CK) 8/CK 18, p63, high molecular weight CK and calponin, and negative for expression of the estrogen receptor and progesterone receptor. Based on the result, an ipsilateral selective neck dissection followed by adjuvant post-operative radiation therapy was suitable at the primary treatment stage. At one year of follow-up, the patient was alive and free of recurrence. In advanced cases of SDC, treatment with anti-HER-2 monoclonal antibodies, such as trastuzumab, is recommended.
Highlights
Salivary duct carcinomas (SDC) are aggressive, high‐grade salivary malignancies first described by Kleinsasser et al [1]
In the present case study, it was observed that the intraductal component of the primary foci and the malignant lymph nodes exhibited central comedo necrosis associated with a cribriform, solid or micropapillary architecture (Fig. 2A and B)
SDC is generally a hematoxylin and eosin stain‐based diagnosis, specific immunohistochemical and staining techniques may confirm a diagnosis in certain cases, and immunomarkers may be beneficial for future therapeutic approaches
Summary
Salivary duct carcinomas (SDC) are aggressive, high‐grade salivary malignancies first described by Kleinsasser et al [1]. The present case study reviews the clinical data of a patient with SDC in the deep lobe of the parotid gland and discusses the relevant literature. Magnetic resonance imaging (Fig. 1) identified a neoplasm of ~2 cm in diameter located in the deep lobe of the parotid gland and involving the exofacial parotid gland This lesion was clinically and radiologically classified as cT3cNxcM0 according to the World Health Organization International Classification of Tumors [5]. The primary surgical treatment for the patient consisted of a total parotidectomy conserving the facial nerve and a modified ipsilateral radical neck dissection, as the intraoperative histology suggested a malignant tumor. Post‐operative radiation therapy (60 Gy; 2 Gy, twice a day, five days a week) was applied to the surgical bed and the right neck area due to the aggressive nature of the tumor. The final pathological staging was pT4pN2pM0, and three years after treatment, the patient remains free from tumor recurrence
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