Baldassarre Bianca Maria, Penner Federica, Bertero Luca, Di Perna Giuseppe, Ajello Marco, Marengo Nicola, Zenga Francesco, Garbossa Diego
Department of Neuroscience, Neurosurgery Unit, Città Della Scienza e Della Salute, Italy.
Department of Pathologic, Città Della Scienza e Della Salute, Turin, Italy.
Surg Neurol Int. 2021 Mar 30;12:122. doi: 10.25259/SNI_903_2020. eCollection 2021.
The salivary duct carcinomas (SDCs) are rare, high-grade neoplasms involving major salivary glands. Parotid is the most frequently involved gland (85%). Apocrine phenotype (histological presence of decapitation secretions) and androgen reception expression define SDC. The clinical course of these tumors is characterized by aggressive local behavior with extraglandular extension, high recurrence rates, early metastases, and poor prognoses. Despite aggressive surgical/radiation therapy management, the rates of locoregional and metastatic relapses are high, and the mortality rates over 48 months approach 65%. Notably, there is no treatment algorithm available for managing vertebral metastases from apocrine SDC.
An elderly male presented with MR/CT findings of an isolated T11 vertebral metastasis attributed to a previously treated parotid SDC. On both CT/MR, it was an osteolytic lesion and demonstrated spinal canal infiltration. The patient underwent surgical biopsy/decompression/resection, following which the lesion histopathologically proved to be a SDC. The patient was subsequently treated with 30 Gy in 10 fractions within 2 weeks of discharge. One-month later, the MRI confirmed adequate epidural decompression without recurrence, and 9 months post-operatively, patient remained disease free.
Isolated metastasis attributed to parotid SDC followed by radiation therapy may result in tumor control.
涎腺导管癌（SDCs）是一种罕见的、高级别肿瘤，主要累及大涎腺。腮腺是最常受累的腺体（85%）。顶泌汗腺表型（断头分泌的组织学表现）和雄激素受体表达可定义涎腺导管癌。这些肿瘤的临床病程以侵袭性局部行为为特征，包括腺外扩展、高复发率、早期转移和预后不良。尽管采用了积极的手术/放疗管理，但局部区域和远处转移复发率仍然很高，48个月后的死亡率接近65%。值得注意的是，目前尚无治疗顶泌汗腺型涎腺导管癌椎体转移的治疗方案。
一名老年男性患者，磁共振成像（MR）/计算机断层扫描（CT）显示孤立的T11椎体转移瘤，归因于先前治疗过的腮腺涎腺导管癌。CT/MR均显示为溶骨性病变，并伴有椎管浸润。患者接受了手术活检/减压/切除，术后病理证实为涎腺导管癌。患者出院后2周内分10次接受了30 Gy的放疗。1个月后，MRI证实硬膜外减压充分，无复发，术后9个月患者仍无疾病复发。
腮腺涎腺导管癌孤立转移瘤行放疗后可能实现肿瘤控制。
