Berendika Jelena, Jungić Saša, Tubić Biljana, Malčić Kecman Gordana, Rakita Ivanka, Gojković Zdenka, Vještica Milka, Nikić Gordan, Babić Božana
Oncology Clinic, University Clinical Centre of the Republic of Srpska, Banja Luka, Bosnia and Herzegovina.
University of Banjaluka Faculty of Medicine, Banja Luka, Bosnia and Herzegovina.
Case Rep Oncol. 2021 Mar 29;14(1):610-615. doi: 10.1159/000514850. eCollection 2021 Jan-Apr.
Malignant salivary gland tumors form 11% of all head and neck tumors. Salivary duct carcinoma (SDC) of the parotid gland is an uncommon and highly aggressive tumor accounting for 2% of all salivary gland malignancies. The fourth edition of the WHO Classification of Head and Neck Tumors reported global annual incidence of 0.4-2.6/100,000 people. Standard treatment for SDC is wide surgical resection along with lymph node dissection followed by adjuvant radiation therapy. The role of adjuvant chemotherapy is not known. Here, we present a case of an SDC of the parotid gland in a 55-year-old female. She presented with a painless swelling behind her right ear. Surgery was performed, and total right parotidectomy was done along with selective neck dissection (levels II, III, VA). The pathology report concluded that it was a G3 (poorly differentiated) SDC (micropapillary variant) with lymphovascular and perineural invasion. The clinical stage of the disease was T4aN2bM0. Adjuvant therapy consisted of concurrent radiation (TD 66 Gy) and chemotherapy with weekly paclitaxel (45 mg/m), carboplatin (AUC 1.5), and trastuzumab (2 mg/kg; THC) for 6 weeks followed by 4 cycles of THC every 3 weeks. Adjuvant trastuzumab was continued for a total of 1 year. She is still without the evidence of the disease 7 years later. The consensus regarding the use of adjuvant chemotherapy does not exist. Based on all the data that have been presented before, the conclusion is that we need new treatment modalities to improve the outome of this aggressive disease.
恶性涎腺肿瘤占所有头颈部肿瘤的11%。腮腺涎腺导管癌（SDC）是一种罕见且侵袭性很强的肿瘤，占所有涎腺恶性肿瘤的2%。《世界卫生组织头颈部肿瘤分类》第四版报告全球年发病率为0.4 - 2.6/10万人口。SDC的标准治疗方法是广泛手术切除并进行淋巴结清扫，随后进行辅助放疗。辅助化疗的作用尚不清楚。在此，我们报告一例55岁女性腮腺SDC病例。她表现为右耳后无痛性肿胀。进行了手术，行右侧腮腺全切除术及选择性颈部清扫术（Ⅱ、Ⅲ、ⅤA区）。病理报告显示为G3（低分化）SDC（微乳头亚型），伴有脉管和神经侵犯。疾病临床分期为T4aN2bM0。辅助治疗包括同步放疗（总剂量66 Gy）和化疗，每周使用紫杉醇（45 mg/m²）、卡铂（AUC 1.5）和曲妥珠单抗（2 mg/kg；THC），共6周，随后每3周进行4个周期的THC治疗。辅助性曲妥珠单抗持续使用共1年。7年后她仍无疾病证据。关于辅助化疗的使用尚无共识。基于之前所呈现的所有数据，结论是我们需要新的治疗模式来改善这种侵袭性疾病的治疗结果。
