Salivary duct carcinoma of the supraglottis with a distinct presentation

Abstract

Rationale:Salivary duct carcinoma (SDC) is a rare and aggressive subtype of salivary gland carcinoma that histologically resembles in situ and invasive ductal carcinoma of the breast. We present the first case of advanced SDC of the minor salivary gland arising from the supraglottis and review the literature on the clinicopathologic characteristics and prognosis of SDC.Patient concerns:A 59-year-old male patient with progressive difficulty in swallowing and a muffled voice for 2 months.Diagnoses:The patient was diagnosed with SDC arising from the supraglottis with extensive tumor invasion into the subsites of the larynx and pharynx.Interventions:Due to impending airway obstruction, the patient underwent CO2 laser debulking surgery. In addition to local disease, lymph node and distant metastases were also noted at diagnosis and concurrent chemoradiation therapy was arranged.Outcomes:Laryngeal function was preserved and tracheostomy was avoided. The patient has survived for >1 year after the initial diagnosis.Lessons:SDC is a rare and aggressive subtype of salivary gland carcinoma that histologically resembles in situ and invasive ductal carcinoma of the breast. Here we presented the first case of advanced SDC of the minor salivary gland arising from the supraglottis that was treated with CO2 laser debulking surgery followed by concurrent chemoradiation therapy. Due to their rarity, further studies are required to establish the most effective treatment protocol for advanced SDC.

Salivary Duct Carcinoma with Late Distant Brain and Cutaneous Metastasis: A Case Report

“…High-grade SDC is histopathologically characterized by proliferation of dysplastic cells containing large round to oval nuclei with conspicuous nucleoli and rich eosinophilic cytoplasm, occasionally accompanied by comedo necrosis, which resembles high-grade breast carcinoma. The immunohistochemical characteristics of SDC cells include positive staining for human epidermal growth factor receptor (HER) 2, AR and CK7 ( 2 , 4 ). Since most salivary gland malignancies have positive immunoreactivity for CK7, immunoexpression of this protein may provide valuable information to differentiate primary salivary gland carcinomas from metastatic tumors ( 9 ).…”

“…Although complete surgical resection and ipsilateral neck dissection followed by postoperative radiation comprise the standard treatment for SDC ( 10 - 12 ), the reported survival rate is 43% for the 5-year disease-specific survival and 36% for the disease-free survival ( 2 , 13 ). Johnston et al reported that 37.5% of the patients with local and regional recurrence of SDC showed distant metastases ( 14 ).…”

“…SDC is estimated to account for 1-3% of all salivary gland malignancies ( 2 , 3 , 4 ). It has a poor prognosis due to its rapid growth, distant metastasis, early regional metastasis, and high rate of recurrence ( 2 ). The parotid gland is the most common site of involvement ( 2 - 5 ).…”

“…It has a poor prognosis due to its rapid growth, distant metastasis, early regional metastasis, and high rate of recurrence ( 2 ). The parotid gland is the most common site of involvement ( 2 - 5 ). SDC may also be observed in the submandibular and minor salivary glands, predominantly in the palate ( 2 ).…”

“…The parotid gland is the most common site of involvement ( 2 - 5 ). SDC may also be observed in the submandibular and minor salivary glands, predominantly in the palate ( 2 ). Surgical resection of the tumor and ipsilateral neck dissection followed by chemotherapy and radiotherapy is currently the most common treatment protocol for SDC ( 4 ).…”