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声门上区涎腺导管癌的独特表现:一例病例报告及文献复习

Salivary duct carcinoma of the supraglottis with a distinct presentation: A case report and literature review.

作者信息

Hsu Cheng-Chieh, Li Wing-Yin, Chu Pen-Yuan

机构信息

Department of Otolaryngology-Head and Neck Surgery Department of Pathology, Taipei Veterans General Hospital School of Medicine, National Yang-Ming University, Taipei, Taiwan.

出版信息

Medicine (Baltimore). 2018 Mar;97(11):e0095. doi: 10.1097/MD.0000000000010095.

Abstract

RATIONALE

Salivary duct carcinoma (SDC) is a rare and aggressive subtype of salivary gland carcinoma that histologically resembles in situ and invasive ductal carcinoma of the breast. We present the first case of advanced SDC of the minor salivary gland arising from the supraglottis and review the literature on the clinicopathologic characteristics and prognosis of SDC.

PATIENT CONCERNS

A 59-year-old male patient with progressive difficulty in swallowing and a muffled voice for 2 months.

DIAGNOSES

The patient was diagnosed with SDC arising from the supraglottis with extensive tumor invasion into the subsites of the larynx and pharynx.

INTERVENTIONS

Due to impending airway obstruction, the patient underwent CO2 laser debulking surgery. In addition to local disease, lymph node and distant metastases were also noted at diagnosis and concurrent chemoradiation therapy was arranged.

OUTCOMES

Laryngeal function was preserved and tracheostomy was avoided. The patient has survived for >1 year after the initial diagnosis.

LESSONS

SDC is a rare and aggressive subtype of salivary gland carcinoma that histologically resembles in situ and invasive ductal carcinoma of the breast. Here we presented the first case of advanced SDC of the minor salivary gland arising from the supraglottis that was treated with CO2 laser debulking surgery followed by concurrent chemoradiation therapy. Due to their rarity, further studies are required to establish the most effective treatment protocol for advanced SDC.

摘要

原理

涎腺导管癌(SDC)是涎腺癌中一种罕见且侵袭性强的亚型,在组织学上类似于乳腺原位癌和浸润性导管癌。我们报告首例起源于声门上区的小涎腺高级别SDC病例,并回顾关于SDC临床病理特征和预后的文献。

患者情况

一名59岁男性患者,吞咽困难进行性加重,声音嘶哑2个月。

诊断

患者被诊断为起源于声门上区的SDC,肿瘤广泛侵犯喉和咽的亚部位。

干预措施

由于即将出现气道阻塞,患者接受了二氧化碳激光减瘤手术。诊断时除局部病变外,还发现有淋巴结和远处转移,遂安排同步放化疗。

结果

保留了喉功能,避免了气管切开。患者自初次诊断后已存活超过1年。

经验教训

SDC是涎腺癌中一种罕见且侵袭性强的亚型,在组织学上类似于乳腺原位癌和浸润性导管癌。在此我们报告首例起源于声门上区的小涎腺高级别SDC病例,该病例接受了二氧化碳激光减瘤手术,随后进行同步放化疗。由于其罕见性,需要进一步研究以确立针对高级别SDC的最有效治疗方案。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4260/5882407/b17b49a685b9/medi-97-e0095-g001.jpg

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