Gupta Ajay, Lakshmi Narayanan Aadithya, Kashyap Vikas, Gupta Surabhi
Medical Oncology, Indraprastha Apollo Hospitals, New Delhi, IND.
Histopathology and Cytopathology, Indraprastha Apollo Hospitals, New Delhi, IND.
Cureus. 2025 Apr 21;17(4):e82742. doi: 10.7759/cureus.82742. eCollection 2025 Apr.
Salivary duct carcinoma (SDC) is one of the rarest malignancies. It can arise de novo or from pre-existing pleomorphic adenoma (carcinoma ex pleomorphic adenoma - CXPA) and can be very aggressive. Here, we present one such case of a 48-year-old male with relapsed, widely invasive SDC ex pleomorphic adenoma of the parotid that was locally advanced with intracranial extension that was refractory to chemo-radiation. Immunohistochemistry confirmed positivity for human epidermal growth factor receptor-2 (HER2) and androgen receptor (AR). He was started on a combination of trastuzumab, Combined Androgen Blockade (CAB) with leuprolide and bicalutamide, and docetaxel. Follow-up imaging at three months and nine months from treatment initiation demonstrated a complete response, ongoing at 17 months at follow-up. The upfront combination of anti-HER2 therapy, CAB, and chemotherapy resulted in a durable complete response in an aggressive disease. The result obtained from our experience provides valuable insight into the management of a rare and treatment-resistant entity, where large prospective studies without heterogeneity are not possible.
涎腺导管癌（SDC）是最罕见的恶性肿瘤之一。它可原发产生，也可由先前存在的多形性腺瘤发展而来（多形性腺瘤癌变 - CXPA），且具有很强的侵袭性。在此，我们报告一例48岁男性病例，其腮腺多形性腺瘤癌变复发且广泛侵袭，局部进展并伴有颅内侵犯，对放化疗耐药。免疫组化证实人表皮生长因子受体2（HER2）和雄激素受体（AR）呈阳性。他开始接受曲妥珠单抗、亮丙瑞林和比卡鲁胺联合雄激素阻断（CAB）以及多西他赛的联合治疗。治疗开始后三个月和九个月的随访影像学检查显示完全缓解，随访17个月时仍持续缓解。抗HER2治疗、CAB和化疗的初始联合治疗使侵袭性疾病获得了持久的完全缓解。我们的经验所得结果为这种罕见且难治性疾病的治疗提供了有价值的见解，而在此类情况下进行无异质性的大型前瞻性研究是不可能的。
