Liu Feng, Fan Li, Lu Lifang, Guo Hongyi, Nan Jie, Han Fei
Department of Head and Neck Surgery, Shanxi Provincial Cancer Hospital/Shanxi Hospital, Cancer Hospital of Chinese Academy of Medical Sciences Taiyuan 030013, Shanxi, China.
Int J Clin Exp Pathol. 2023 Mar 15;16(3):67-75. eCollection 2023.
Salivary duct carcinoma (SDC) is a rare malignant tumor of the salivary gland and is most commonly found in the parotid gland, followed by the submandibular gland. Due to its rarity, there is no consensus on its treatment. Surgical resection is currently the only curative treatment. Considering its high degree of malignancy, extensive tumor resection and postoperative adjuvant radiotherapy are recommended. We report a rare case of SDC of the submandibular gland. A 62-year-old man presented to our hospital with complaints of swelling in the right submaxillary area for 4 months, rapidly growing, with pain for 10 days. After admission, fine needle aspiration (FNA) revealed right submandibular gland ductal carcinoma. Considering its aggressiveness, large size, and invasion of parapharyngeal and oral floor soft tissues, the patient received two cycles of neoadjuvant chemotherapy followed by extended surgical resection. Postoperatively, the patient received four cycles of concurrent chemoradiotherapy, followed by afatinib targeted therapy. No recurrence or metastasis was observed in a 45-month follow-up. Thus we present a comprehensive treatment for salivary duct carcinoma combining neoadjuvant chemotherapy with surgery, postoperative concurrent radiotherapy, and chemotherapy followed by afatinib targeted therapy.
涎腺导管癌（SDC）是一种罕见的涎腺恶性肿瘤，最常见于腮腺，其次是下颌下腺。由于其罕见性，关于其治疗尚无共识。手术切除是目前唯一的治愈性治疗方法。鉴于其高度恶性，建议进行广泛的肿瘤切除及术后辅助放疗。我们报告一例罕见的下颌下腺涎腺导管癌病例。一名62岁男性因右侧颌下区肿胀4个月、迅速增大且伴有疼痛10天前来我院就诊。入院后，细针穿刺抽吸活检（FNA）显示为右侧下颌下腺导管癌。考虑到其侵袭性、肿瘤体积大以及侵犯咽旁和口底软组织，该患者接受了两个周期的新辅助化疗，随后进行扩大手术切除。术后，患者接受了四个周期的同步放化疗，随后进行阿法替尼靶向治疗。在45个月的随访中未观察到复发或转移。因此，我们提出了一种涎腺导管癌的综合治疗方案，包括新辅助化疗联合手术、术后同步放疗和化疗，随后进行阿法替尼靶向治疗。
