Service de Chirurgie Cervicofaciale, Hôpital du Val-de-Grâce, 74, boulevard de Port-Royal, 75230 Paris cedex 05, France.
Eur Ann Otorhinolaryngol Head Neck Dis. 2011 Sep;128(4):194-6. doi: 10.1016/j.anorl.2010.12.008. Epub 2011 Apr 6.
Salivary duct carcinoma is one of the rarest and most aggressive forms of parotid tumor. We report two cases.
Case 1: a 78-year-old man was referred for a salivary duct carcinoma of the left parotid gland. Treatment was surgical (parotidectomy with ipsilateral selective neck dissection), without capsule rupture, and with healthy margins. At seven years' follow-up, the patient was alive and disease-free. Case 2: a 41-year-old man was referred for a salivary duct carcinoma of the left parotid gland. Parotidectomy with ipsilateral selective neck dissection left healthy but insufficient margins (<1 cm), and postoperative radiation therapy (70 Gy) was undertaken. At eight years' follow-up, the patient was alive and free of recurrence.
Mean patient age in the literature is 60 years, with a male-to-female ratio of 2:1. Mean five-years' recurrence-free survival was 34%.
Surgery is the main form of treatment in this indication. Postoperative radiation therapy is indicated in case of extraparotid extension, pathological resection margins, cervical lymph node metastasis, lymphatic embolus and/or neurologic invasion. Chemotherapy is generally reserved for metastatic forms of the disease.
涎腺导管癌是最罕见和最具侵袭性的腮腺肿瘤之一。我们报告两例病例。
病例 1：一名 78 岁男性因左侧腮腺涎腺导管癌就诊。治疗采用手术（腮腺切除术伴同侧选择性颈部淋巴结清扫术），无包膜破裂，切缘健康。随访 7 年时，患者存活且无疾病。
病例 2：一名 41 岁男性因左侧腮腺涎腺导管癌就诊。行腮腺切除术伴同侧选择性颈部淋巴结清扫术，切缘虽健康但不足 1cm，术后接受了放射治疗（70Gy）。随访 8 年时，患者存活且无复发。
文献中的平均患者年龄为 60 岁，男女比例为 2:1。平均 5 年无复发生存率为 34%。
手术是该适应证的主要治疗形式。对于腮腺外侵犯、病理切缘、颈部淋巴结转移、淋巴管栓子和/或神经侵犯，术后放射治疗是指征。化疗通常保留用于转移性疾病形式。
