Deantoni C L, Midulla M, Mirabile A, Chiara A, Lucchini R, Giannini L, Torrisi M, Fodor A, Di Muzio N G, Dell'Oca I
Radiation Oncology Department IRCCS San Raffaele Scientific Institute, Milan, Italy.
Department of Otorhinolaryngology IRCCS San Raffaele Scientific Institute, Milan, Italy.
Case Rep Ophthalmol Med. 2024 Sep 12;2024:4410206. doi: 10.1155/2024/4410206. eCollection 2024.
Epithelial tumors of lacrimal glands are rare and primary ductal adenocarcinoma of the lacrimal gland accounts for only 2% of all epithelial lacrimal gland tumors. Considering its rarity and lack of uniform diagnostic criteria, treatment protocols are not well defined. In this study, we describe a Her-2 positive case and review previously reported cases. In 2012, a 42-year-old woman affected by primary ductal adenocarcinoma of the lacrimal gland was treated with transpalpebral anterior orbitotomy and adjuvant radiotherapy. In July 2013, she presented local relapse and she underwent orbital exenteration. In November 2013, for neck nodal progression, seven cycles of chemotherapy (cisplatin and epirubicin) associated with a humanized monoclonal antibody-targeting HER 2 therapy (trastuzumab and pertuzumab) were performed, with a marked response rate. Then, she underwent total parotidectomy with right neck lymphadenectomy and adjuvant hadrontherapy. Nine years later (113 months) after treatment completion, the patient was alive without disease and with acceptable toxicity. In primary ductal adenocarcinoma of the lacrimal gland, early diagnosis and multimodal treatments could be crucial, considering its often aggressive tendency. Considering the lack of treatment guidelines, case report recording can be useful in patient management.
泪腺上皮性肿瘤较为罕见，泪腺原发性导管腺癌仅占所有泪腺上皮性肿瘤的2%。鉴于其罕见性以及缺乏统一的诊断标准，治疗方案尚未明确界定。在本研究中，我们描述了1例人表皮生长因子受体2（Her-2）阳性病例，并回顾了既往报道的病例。2012年，1名患有泪腺原发性导管腺癌的42岁女性接受了经睑眶前部切开术及辅助放疗。2013年7月，她出现局部复发，随后接受了眶内容摘除术。2013年11月，因颈部淋巴结转移，她接受了7个周期的化疗（顺铂和表柔比星）联合人源化抗HER 2单克隆抗体治疗（曲妥珠单抗和帕妥珠单抗），反应率显著。之后，她接受了全腮腺切除术及右侧颈部淋巴结清扫术，并进行了辅助强子治疗。治疗结束9年后（113个月），患者存活且无疾病，毒性反应可接受。在泪腺原发性导管腺癌中，鉴于其通常具有侵袭性的倾向，早期诊断和多模式治疗可能至关重要。考虑到缺乏治疗指南，病例报告记录对患者管理可能有用。
