Abstract
BackgroundSalivary duct carcinoma (SDC) is a high-grade salivary gland malignancy that is associated with an aggressive clinical behavior and poor prognosis. Herein, we report on a long surviving case of SDC of the minor salivary gland with multiple lymph node metastases (LNMs).Case presentationAn 83-year-old woman presented with a history of lymphadenopathy in the right side of the neck and recent onset and rapid growth of a mass in the right buccal region. Clinical examinations and biopsy findings were suggestive of a salivary gland malignant tumor with regional LNMs. The patient was treated with neoadjuvant chemotherapy. Tumor excision and ipsilateral radical neck dissection were performed, followed by adjuvant chemoradiotherapy. Postoperative histological examination revealed a tumor with irregular nests of atypical ductal epithelial cells, a cribriform growth pattern, and comedo-like central necrosis that lead to a final diagnosis of SDC. LNMs were observed in six lymph nodes of the right side of the neck. The patient underwent postoperative chemotherapy using single-agent cisplatin that was administered concurrently with radiotherapy (total, 65 Gy). There was no evidence of local recurrence or distant metastasis for >6 years.ConclusionsAlthough available data on treatment modalities for SDC remain limited, multimodal therapy may contribute to improved clinical outcomes in patients with advanced intraoral SDC.
Highlights
Salivary duct carcinoma (SDC) is a high-grade salivary gland malignancy that is associated with an aggressive clinical behavior and poor prognosis
Conclusions: available data on treatment modalities for SDC remain limited, multimodal therapy may contribute to improved clinical outcomes in patients with advanced intraoral SDC
SDC exhibits an aggressive clinical behavior and especially poor prognosis that is characterized by multiple nodal metastases, early distant metastasis (DM), and a high rate of local recurrence [3, 4]
Summary
Salivary duct carcinoma (SDC) is a rare malignant tumor that arises from the ductal epithelial cells of the salivary glands. The patient was seen by a general dental practitioner, when she had first noticed the lesion, and was subsequently referred to the Department of Oral and Maxillofacial Surgery at a local hospital where a diagnosis of a neoplasm of the buccal region was suggested. The tumor was distinct from the parotid gland, suggesting that it had originated from the minor salivary gland of the buccal region. According to these histopathological features, the tumor was diagnosed as a SDC of minor salivary gland origin. The patient has remained alive for >6 years after the initial diagnosis with no evidence of recurrence
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