Department of Head and Neck Surgery, Instituto Nacional de Cancerología (Mexico), Av San Fernando # 22 Col. Sección XVI, Tlalpan, 14080, Mexico City, Mexico.
Department of General Surgery (Head and Neck), Hospital Manuel Gea Gonzalez, Mexico City, Mexico.
Eur Arch Otorhinolaryngol. 2022 Jan;279(1):327-333. doi: 10.1007/s00405-021-06757-x. Epub 2021 Mar 24.
Salivary gland tumors are rare and include benign and malignant entities with different behavior and prognosis. Salivary gland carcinoma accounts for 0.2% of all cancers and 5-9% of head and neck carcinomas. We aim to describe the clinicopathological characteristics and discuss the immunohistochemical findings of salivary ductal carcinoma.
We obtained 17 cases (2.3%) of salivary ductal carcinoma (SDC) from 727 patients with parotid tumors at our cancer center from a database covering a 22-year period (1996-2018). Two pathologists confirmed the diagnosis and excluded 6 cases. Eleven cases were assessed by immunohistochemistry (IHC) for HER2, estrogen receptor (ER), progesterone receptor (PR), androgen receptor (AR), mammaglobin, P53, GATA3, S100, cytokeratins (7,8,14,18, and 20), P63, PAX8, calponin, and SOX10.
Eleven SDC cases were in advanced stage, and 80% had metastasis. All cases were surgically treated, and 40% received different adjuvant chemotherapy regimens. we found that most patients were dead of disease. The histological and immunohistochemical analysis showed that 70% of cases were high-grade, 40% were positive for HER2, and 50% for AR. Moreover, a high Ki-67 proliferative index was detected in all cases. We observed luminal differentiation in 50% of cases.
SDC is a rare entity and survival is very poor. It is histologically similar to ductal carcinoma of the breast. However, important differences exist that help to distinguish them in case of synchronous cancers. The clinical behavior of SDC seems to be more aggressive and IHC analysis is useful for designing therapies.
唾液腺肿瘤较为罕见，包括良性和恶性肿瘤，其具有不同的生物学行为和预后。唾液腺癌占所有癌症的 0.2%，占头颈部癌症的 5-9%。我们旨在描述唾液导管癌的临床病理特征，并讨论其免疫组化表现。
我们从 22 年间（1996 年至 2018 年）数据库中获得了本癌症中心 727 例腮腺肿瘤患者中的 17 例（2.3%）唾液导管癌（SDC）病例。两位病理学家确认了诊断并排除了 6 例。11 例通过免疫组化（IHC）检测 HER2、雌激素受体（ER）、孕激素受体（PR）、雄激素受体（AR）、乳球蛋白、P53、GATA3、S100、细胞角蛋白（7、8、14、18 和 20）、P63、PAX8、钙调蛋白和 SOX10。
11 例 SDC 处于晚期，80%有转移。所有病例均接受手术治疗，40%接受不同的辅助化疗方案。我们发现大多数患者死于疾病。组织学和免疫组化分析显示，70%的病例为高级别，40%的病例 HER2 阳性，50%的病例 AR 阳性。此外，所有病例的 Ki-67 增殖指数均较高。我们观察到 50%的病例存在管腔分化。
SDC 是一种罕见的实体瘤，患者的生存情况极差。它在组织学上与乳腺导管癌相似。然而，存在一些重要的差异，有助于在同时发生癌症的情况下对其进行鉴别。SDC 的临床行为似乎更具侵袭性，免疫组化分析有助于制定治疗方案。
