Case Of Salivary Duct Carcinoma Research Articles

POSTOPERATIVE RADIOTHERAPY IN SALIVARY DUCTCARCINOMA: A CASE REPORT AND REVIEW OF THE LITERATURE

Salivary duct carcinoma(SDC) is a rare and aggressive tumor of the salivary glands that often occurs in men between the fifth and sixth decades of life. standard treatment is based on wide surgical resection of the primary tumor with lymph node dissection, followed by postoperative radiotherapy. The place of chemotherapy in the treatment of SDC remains unknown. In this publication, authors report a case of SDC of the left parotid gland. A 28-year-old male suffered from a painful neck mass associated with hearing loss that had been evolving for 6 months. The patient initially had a cervical CT scan and a parotid MRI, which showed a tumor of the left parotid gland. He initially had a total parotidectomy preserving the facial nerve with an ipsilateral neck dissection, as the intraoperative histological examination was in favor of malignancy. The final analysis of the surgical specimen concluded to a ductal carcinoma of the parotid with lymph node metastasis. Adjuvant radiation therapy has been indicated. The evolution was unfavorable due to the appearance of multisite metastases after one year.

Algorithm for the reconstruction of the parotid region: a single institution experience

ObjectiveThis study aims to discuss the characteristics and treatment methods of malignant tumors in the parotid region, as well as the therapeutic effects of immediate free flap reconstruction of soft tissue for postoperative defects.Materials and methodsA retrospective review was conducted on 11 cases of soft tissue flap reconstruction for postoperative defects following the resection of malignant tumors in the parotid region. Statistical analysis was performed based on clinical data.ResultsAmong the 11 cases of malignant tumors in the parotid region, there were 2 cases of secretory carcinoma (SC) of the salivary gland, 2 cases of squamous cell carcinoma (SCC), 2 cases of carcinosarcoma, 1 case of mucoepidermoid carcinoma (MEC), 1 case of epithelial-myoepithelial carcinoma (EMC), 1 case of salivary duct carcinoma (SDC), 1 case of basal cell carcinoma (BCC), and 1 case of osteosarcoma. Among these cases, 4 were initial diagnoses and 7 were recurrent tumors. The defect repairs involved: 8 cases with anterolateral thigh free flap (ALTF), 2 cases with pectoralis major muscle flaps, and 1 case with forearm flap. The size of the flaps ranged from approximately 1 cm × 3 cm to 7 cm × 15 cm. The recipient vessels included: 4 cases with the facial artery, 4 cases with the superior thyroid artery, and 1 case with the external carotid artery. The ratio of recipient vein anastomosis was: 57% for branches of the internal jugular vein, 29% for the facial vein, and 14% for the external jugular vein. Among the 8 cases that underwent neck lymph node dissection, one case showed lymph node metastasis on pathological examination. In the initial diagnosis cases, 2 cases received postoperative radiotherapy, and 1 case received 125I seed implantation therapeutic treatment after experiencing two recurrences. Postoperative follow-up revealed that 2 cases underwent reoperation due to local tumor recurrence, and there were 2 cases lost to follow-up. The survival outcomes after treatment included: one case of distant metastasis and one case of death from non-cancerous diseases.ConclusionImmediate soft tissue flap reconstruction is an important and valuable option to address postoperative defects in patients afflicted with malignant tumors in the parotid region.

Salivary Duct Carcinoma Arising in a Warthin Tumor of the Parotid Gland: A Rare Case Report with Review of Literature and PD-L1 Expression.

Warthin's tumor is the second most common neoplasm of the parotid gland and consists of 2 components, including lymphoid stroma and glandular epithelium. Malignant transformation in this tumor is mostly seen in the lymphoid component; however, the carcinomatous transformation of the epithelial component is extremely rare. Cases of latter reported in the literature include squamous cell carcinoma, adenocarcinoma, mucoepidermoid carcinoma, oncocytic carcinoma, Merkel cell carcinoma, and undifferentiated carcinoma. We describe an extremely rare case of salivary duct carcinoma arising in a Warthin tumor in a 64-year-old male. Patient presented with an enlarging left parotid mass, biopsy of which showed salivary duct carcinoma. He subsequently underwent left parotidectomy along with left level II-IV lymph node dissection. Histology revealed both in situ as well as invasive salivary duct carcinoma arising from Warthin tumor. Immunohistochemistry showed tumor cells positive for CK7, AR, and GATA3, while p63 highlighted the myoepithelial cell layer in the in situ component. Her2 was 2+ by immunohistochemistry. In addition, PD-L1 IHC revealed positive expression with a combined positive score of 20%.

A case of salivary duct carcinoma possibly arising from pleomorphic adenoma

Objective: We report a rare case of salivary duct carcinoma possibly arising from the malignant component of carcinoma ex pleomorphic adenoma.
 Methods: A 56-year-old Japanese male complained of swelling in the left side of jaw for 2 years which was painless until 2 days ago. On extraoral examination, the face was bilaterally asymmetrical. An ultrasonography revealed hypoechoic mass of size 1.5x2.5x2.5 cm on left parotid gland. Computed tomography (CT) revealed a slight irregular mass on left parotid gland with no infiltration to adjacent tissues. Based on these findings, a clinical diagnosis of left parotid benign tumor was made.
 Results: A surgical excision was performed under general anesthesia. On histopathological examination, the connective tissue was rich in fibrous components and was accompanied by hyaline. Epithelial cells with high atypia proliferating invasively as cords into connective tissue were observed. The intraductal component had Roman-bridge-like architecture with central portion undergoing comedonecrosis. Based on these findings, a final diagnosis of salivary duct carcinoma possibly arising from pleomorphic adenoma was made. p16 hypermethylation is a known phenomenon in oral malignancy. We also checked the methylation status of p16 gene and found high level of methylation in this tumor.
 Conclusion: We reported a rare case of salivary duct carcinoma possibly arising from pleomorphic adenoma and also demonstrated high methylation level of p16 gene in the tumor.

Salivary Duct Carcinoma arising from pre-existing Epithelial-Myoepithelial Carcinoma of the parotid gland: Another rare example with Cytological Correlation

An extremely exceptional case of salivary duct carcinoma (SDC) arising from pre-existing epithelial-myoepithelial carcinoma (EMC) of the parotid gland is herein described. The patient was a 50-year-old Japanese female, who presented with an asymptomatic mass of the right parotid gland that had been present for approximately 7 years. A superficial lobectomy of the parotid gland was performed and there have been no symptoms of recurrence or distant metastasis during over 10-year follow-up period. Histologically, the tumor was composed of an EMC component having double-layered ducts and invasive nests of myoepithelial clear cells with an SDC component intermingled throughout the lesion, which consisted of eosinophilic pleomorphic cells. Nests of the SDC component were occasionally accompanied by small luminal structures and minimally focalized comedo necrosis, and were immunoreactive for androgen receptor and GCDFP15. Fine needle aspiration cytology showed moderate cellularity, a few three-dimensional or sheet-like clusters, and single dispersed cells with abundant granular cytoplasm in the background. Furthermore, hyperchromatic small or flattened cells were identified attaching to the periphery of the clusters in retrospective observation. Metachromasia was also seen in May-Grunwald Giemsa stain. Keywords: Salivary duct carcinoma; Epithelial-myoepithelial carcinoma; Parotid gland; Dedifferentiation; High-grade transformation; Fine needle aspiration cytology

Le carcinome canalaire de la parotide : une entité rare et agressive

We report a rare case of salivary duct carcinoma and we study its clinical and evolutionary features. A 64-year-old patient was referred for right peripheral facial paralysis. MRI showed suspected formation of the right parotid gland. Treatment included total parotidectomy and ipsilateral neck lymph node dissection. The histology concluded to a ductal carcinoma of the parotid with lymph node metastasis. Radiation therapy has been indicated. Salivary duct carcinoma of the parotid gland is a highly aggressive and uncommon tumor. Treatment of localized forms is based on surgery and radiotherapy.

SALIVARY DUCT CARCINOMA, A CASE REPORT

Objective We report a case of salivary duct carcinoma outside age of presentation and with a rare location. Case report A 31-year-old male patient who arrived to Hospital Juarez de Mexico, complaining of an 8 month tissue increase in the submental region, right neck and right face paresthesia. CT scan showed a submandibular tumor that infiltrated the floor of the mouth and base of the ipsilateral tongue with multiple right neck adenopathies levels IB, II, III and IV. Histologically, the lesion displayed cellular and nuclear pleomorfic epitelial cells, with abundant eosinofilic citoplasm, focal central necrosis, cribriform architectural pattern reminiscent of the image of “Roman bridges”. An inmunohistochemical profile was performed: androgen receptors (+), GATA-3 (+), cytokeratin 7 (+) and p-63 (-). A diagnosis of salivary duct carcinoma was emited. Discussion Salivary duct carcinoma is an aggressive malignant epithelial neoplasm, which may occur de novo or as a component of a carcinoma ex-pleomorphic adenoma. It constitutes only 3-6% of all salivary gland neoplasms. With a male predilection, affecting individuals between the 6th and 7th decades of life. Microscopically, it is characterized by celular and nuclear pleomorphism, atypical mitoses, and a cribiform pattern with dilated ducts. Conclusion Salivary duct carcinoma is an aggressive and rare salivary gland neoplasm, we present this case which differs in age and location usually reported.

A case of salivary duct carcinoma of submandibular gland presented diagnostic difficulty

Background: In general, malignant tumors arising from salivary gland are uncommon and salivary duct carcinoma (SDC) is extremely rare but highly aggressive in head and neck region. As previously reported, the diagnosis by clinical examinations has a major challenge due to its variety of differential diagnosis. Here we show a case of SDC developed in submandibular gland showing a poor diagnosis by clinical findings including radiographic features.

A Case of Salivary Duct Carcinoma Arising from Submandibular Gland

A Case of Salivary Duct Carcinoma Arising from Submandibular Gland

A Case of Salivary Duct Carcinoma in the Submandibular Gland Treated Long-term with a Combination of Trastuzumab and Docetaxel

A Case of Salivary Duct Carcinoma in the Submandibular Gland Treated Long-term with a Combination of Trastuzumab and Docetaxel

A case of salivary duct carcinoma exhibiting sarcomatoid changes in the metastatic lesions

A case of salivary duct carcinoma exhibiting sarcomatoid changes in the metastatic lesions

ドセタキセルとトラスツズマブを長期間投与した顎下腺原発唾液腺導管癌例

ドセタキセルとトラスツズマブを長期間投与した顎下腺原発唾液腺導管癌例

Salivary Duct Carcinoma of the Deep Lobe of the Parotid Gland: A Rare Clinical Finding.

Salivary Duct Carcinoma of the Deep Lobe of the Parotid Gland: A Rare Clinical Finding.

胸水に出現し, 免疫細胞化学染色が診断に有用であった唾液腺導管癌の 1 例

胸水に出現し, 免疫細胞化学染色が診断に有用であった唾液腺導管癌の 1 例

IgG4関連疾患に合併した顎下腺唾液腺導管癌の1例

IgG4関連疾患は，唾液腺に病変がみられることが多く，耳鼻咽喉科医が診断することも多い。最近は，悪性腫瘍を合併しやすいことが報告されている。今回，IgG4関連疾患に顎下腺唾液腺導管癌を合併した1例を経験したので報告する。症例は67歳女性。検診で受けたPET-CTで，全身のリンパ節腫脹を指摘された。顎下部のリンパ節と考えていた腫瘤は顎下腺腫瘍であり，IgG4陽性形質細胞の浸潤を背景とした唾液腺導管癌がみられた。血清IgG4が高値であり，IgG4関連疾患に合併した顎下腺唾液腺導管癌と診断した。今のところ，頭頸部において悪性腫瘍の合併に関する報告は少ないが，念頭に置いておくべきと考える。

耳下腺開口部に生じた唾液腺導管癌の1例

In the present study, we summarize our experience with a case of salivary duct carcinoma occurring in the orifice of the parotid gland that was suggested to originate in Stensen’s duct. The patient was a 78-year-old man who consulted our hospital because of a mass in the left buccal mucosa. Although a biopsy strongly indicated salivary duct carcinoma, no cervical lymph node metastasis or distant metastasis was evident; therefore only local resection was performed. The tumor was located near the orifice of the parotid gland. Because the histopathological examination showed that the ductal epithelium was continuous around the tumor, the tumor was considered to be a salivary duct carcinoma that had developed in Stensen’s duct at the orifice of the parotid gland. After postoperative radiation, there has been no evidence of recurrence or metastasis for 3 years.

ワルチン腫瘍と唾液腺導管癌が同時性に発生した1例

ワルチン腫瘍と唾液腺導管癌が同時性に発生した1例

PIK3CA Mutations and PTEN Loss in Salivary Duct Carcinomas

Salivary duct carcinoma (SDC) is an aggressive malignancy that frequently presents at an advanced stage. Mutations/amplification of the gene encoding the p110α catalytic subunit of phosphoinositide 3-kinase (PIK3CA) and/or loss of the phosphatase and tensin homolog (PTEN) are known to activate the phosphoinositide 3-kinase (PI3K) pathway and may represent a therapeutic target. In 7 of 34 SDCs (20.5%) a SNaPshot polymerase chain reaction detected PIK3CA exon 9 [p.E545K (n=3) and p.E542K (n=2)] or exon 20 [p.H1047R (n=2)] mutations. PIK3CA p.E545K mutation was identified in 3 de novo SDCs with conventional morphology. The only case of SDC with anaplastic transformation showed PIK3CA p.H1047R mutation, whereas 1 of 2 PIK3CA p.E542K mutations was identified in SDC arising in a pleomorphic adenoma. None of the 16 tested SDCs showed PIK3CA amplification by fluorescence in situ hybridization. Fluorescence in situ hybridization identified PTEN loss in 8 of 16 tested SDCs (50%) [homozygous deletion (n=3), chromosome 10 monosomy (n=3), hemizygous deletion (n=2)]. Two cases showed both PIK3CA mutation and PTEN loss, suggesting that these events are not mutually exclusive. These findings offer a molecular rationale for therapeutic targeting of the PI3K pathway in patients with SDC.

Salivary Duct Carcinoma of the Accessory Parotid Gland

Objective: 1) Present a rare case of salivary duct carcinoma of the accessory parotid gland (APG). 2) Understand the current prevalence, diagnosis, and management of benign and malignant tumors of the APG.Method: This study includes a case presentation and literature review. The literature review included articles from October 1966 to January 2010 and included all cases of accessory parotid gland tumors in adults.Results: One hundred and nineteen cases with 19 different tumor types were reported in the accessory parotid gland (APG). Pleomorphic adenoma and mucoepidermoid carcinoma represented 50% and 23%, respectively. There were no previously reported salivary duct carcinomas of the APG. Forty percent of APG neoplasms were malignant. This malignancy rate was comparable to previous studies reporting a higher rate of malignant tumors in the APG compared with 15% to 20% in parotid tumors. A standard parotidectomy remains the preferred approach with less risk to the facial nerve compared with direct cheek re...

Primary minor salivary gland salivary duct carcinoma at palate: A radiological investigation and review of the literature

Salivary duct carcinoma (SDC) is regarded as high-grade malignancy with accompanied by bone destruction originating in the ductal epithelium of salivary gland. SDC arising in the minor salivary gland of the oral cavity is very rare. We present here a single case of SDC arising from the minor salivary gland of a 82-year-old man. His first symptom was swelling on the left side of the palate. There is no bone resorption by the results of imaging studies, so benign tumor located in minor salivary gland was suspected. The tumor was dissected surgically and the intraductal component is microscopically described as a cribriform, papillary, solid growth pattern, with central necrosis. Immunohistochemical staining of intraductal component cells was positive for human epidermal growth factor receptor type2 (Her2), gross cystic disease fluid protein-15 (GCDFP-15) and androgen receptor (AR). As a result, the tumor was diagnosed as a SDC.