Complex Treatment of Rare Aggressive Salivary Duct Carcinoma-A Clinical Case From Our Practice
Author(s):
L. Marinova, V. Vasileva, N. Kahchiev and Katia Sergieva
Salivary duct carcinoma (SDC) is a rare, aggressive salivary neoplasm. We present a 64-year-old woman with locally advanced salivary duct carcinoma of the left parotid gland with metastatic involvement of the left cervical lymph nodes. A radical left-sided parotidectomy with left-sided cervical lymphatic dissection was performed. Given the advanced disease/pT4 pN2b M0, as well as the aggressive nature of the proven carcinoma, the patient was referred for postoperative combined chemoradiotherapy (Ch-RT). Despite aggressive complex local treatment, on the background of achieved local and regional tumor control, at the sixth month after its completion, PET/CT proved metabolically active accumulation in the left extra-regional axillar lymph nodes and in the left occipital implantation metastases. Strict pathohistological and differential diagnosis of this rare, aggressive tumor requires immunohistochemical analysis of androgen receptors (AR), which are usually positive. In case of distant metastatic dissemination, it is necessary to carry out AR target therapy.