Uchihashi Toshihiro, Kodama Shingo, Sugauchi Akinari, Hiraoka Shinichiro, Hirose Katsutoshi, Usami Yu, Tanaka Susumu, Kogo Mikihiko
First Department of Oral and Maxillofacial Surgery, Osaka University Graduate School of Dentistry, Suita 565-0871, Osaka, Japan.
Department of Oral Pathology, Osaka University Graduate School of Dentistry, Suita 565-0871, Osaka, Japan.
World J Clin Cases. 2021 Apr 26;9(12):2908-2915. doi: 10.12998/wjcc.v9.i12.2908.
Salivary duct carcinoma (SDC) is a rare, extremely aggressive malignancy that arises in the submandibular gland. It can metastasize locally early and therefore is an important differential diagnosis of metastatic disease in cervical lymph nodes or specific lymphadenitis such as tuberculous cervical lymphadenitis.
We report a case of SDC in the submandibular gland that presented diagnostic difficulty. The lesion was coincidentally discovered through examination of the radiolucent area of the maxilla. Imaging failed to confirm the possibility of specific inflammation, leading us to execute an open biopsy to verify the diagnosis. The surgical specimen showed that the submandibular gland was primarily replaced with a calcified body. Following histological analysis and confirmation, we performed surgical resection, radiotherapy, and various chemotherapies.
Radiographic imaging characteristics of lymph node metastases of salivary gland cancer, especially of SDC, may resemble other cervical lymphadenitis; calcification at the submandibular gland is the landmark of SDC occurring at the subman-dibular gland.
涎腺导管癌（SDC）是一种罕见的、极具侵袭性的恶性肿瘤，起源于下颌下腺。它可早期发生局部转移，因此是颈部淋巴结转移性疾病或特定淋巴结炎（如结核性颈部淋巴结炎）的重要鉴别诊断。
我们报告一例下颌下腺涎腺导管癌病例，该病例在诊断上存在困难。该病变是通过对上颌骨透射区的检查偶然发现的。影像学检查未能证实存在特定炎症的可能性，这促使我们进行开放性活检以核实诊断。手术标本显示下颌下腺主要被一个钙化体取代。经过组织学分析和确诊后，我们进行了手术切除、放疗和多种化疗。
涎腺癌尤其是涎腺导管癌的淋巴结转移的影像学特征可能与其他颈部淋巴结炎相似；下颌下腺钙化是下颌下腺发生涎腺导管癌的标志。
