Department of Radiotherapy, Batra Hospital And Medical Research Centre (BHMRC), New Delhi, India.
Perm J. 2022 Jun 29;26(2):158-161. doi: 10.7812/TPP/21.205. Epub 2022 Jun 15.
Introduction Apocrine carcinoma, a cancer of sweat glands, is very rare, with a global incidence of 0.0049 to 0.0173 cases per 100,000 persons annually. It is usually found in axilla and anogenital areas. The intraductal apocrine variety of salivary duct carcinoma in the parotid gland is very rare and aggressive and may be due to ectopic sweat glands in the parotid gland duct or metaplastic change of the salivary duct epithelium. It usually presents in an advanced stage. Even though surgery is the standard of care in most head and neck cancers, there are no standard guidelines for the treatment of intraductal apocrine parotid carcinoma, which is different from other head and neck cancers due to its rare incidence, aggressive behavior, and poor prognosis. Case presentation We present a rare case of intraductal apocrine salivary duct carcinoma of the left parotid gland, presented in a locally advanced stage with very high chances of recurrence after surgery, and discuss the role of volumetric modulated arc technique radiotherapy in its management. Conclusion Intraductal apocrine salivary duct carcinoma usually has androgen receptor expression, and lack of expression is associated poor prognosis. Even with complete resection, it has a high recurrence rate. Volumetric modulated arc technique radiotherapy (VMAT) decreases recurrence and increases survival by irradiating the areas more likely of recurrence, with minimal toxicity to surrounding normal tissues.
介绍 大汗腺癌是一种罕见的汗腺癌，全球每年每 10 万人中有 0.0049 至 0.0173 例。它通常发生在腋窝和肛门生殖器区域。腮腺内导管型大汗腺癌非常罕见且具有侵袭性，可能是由于腮腺导管中的异位汗腺或唾液腺上皮的化生改变。它通常处于晚期。尽管手术是大多数头颈部癌症的标准治疗方法，但由于其罕见的发病率、侵袭性行为和不良预后，对于导管内大汗腺癌的治疗尚无标准指南，这与其他头颈部癌症不同。
病例介绍 我们报告了一例罕见的左侧腮腺内导管型大汗腺癌病例，表现为局部晚期，手术后复发的可能性非常高，并讨论了容积旋转调强放疗（VMAT）在其治疗中的作用。
结论 内导管型大汗腺癌通常表达雄激素受体，缺乏表达与预后不良相关。即使完全切除，其复发率也很高。VMAT 通过照射更有可能复发的区域，同时对周围正常组织的毒性最小，从而降低复发率并提高生存率。
