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Carillo AM, De Luca C, Pisapia P, Vigliar E, Ikenberg K, Freiberger SN, Troncone G, Rupp NJ, Bellevicine C. Molecular testing in salivary gland cytopathology: A practical overview in conjunction with the Milan system. Cytopathology 2024; 35:330-343. [PMID: 38308401 DOI: 10.1111/cyt.13363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Revised: 01/17/2024] [Accepted: 01/18/2024] [Indexed: 02/04/2024]
Abstract
Recently, significant advances in the molecular characterization of salivary gland neoplasms have facilitated the classification and diagnosis of specific diagnostic entities. In the highly challenging diagnostic scenario of salivary malignancies, molecular testing is increasingly being adopted in routine practice to refine the cytological diagnosis of salivary lesions. Here, we reviewed the most recent evidence in the field of salivary glands molecular cytopathology.
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Affiliation(s)
- Anna Maria Carillo
- Department of Public Health, University of Naples Federico II, Naples, Italy
| | - Caterina De Luca
- Department of Public Health, University of Naples Federico II, Naples, Italy
| | - Pasquale Pisapia
- Department of Public Health, University of Naples Federico II, Naples, Italy
| | - Elena Vigliar
- Department of Public Health, University of Naples Federico II, Naples, Italy
| | - Kristian Ikenberg
- Department of Pathology and Molecular Pathology, University Hospital Zurich, Zurich, Switzerland
| | - Sandra N Freiberger
- Department of Pathology and Molecular Pathology, University Hospital Zurich, Zurich, Switzerland
| | - Giancarlo Troncone
- Department of Public Health, University of Naples Federico II, Naples, Italy
| | - Niels J Rupp
- Department of Pathology and Molecular Pathology, University Hospital Zurich, Zurich, Switzerland
- Faculty of Medicine, University of Zurich, Zurich, Switzerland
| | - Claudio Bellevicine
- Department of Public Health, University of Naples Federico II, Naples, Italy
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Jain R, Sansoni ER, Angel J, Gleysteen JP, Hayes DN, Owosho AA. Salivary Duct Carcinoma with Rhabdoid Features of the Parotid Gland with No E-Cadherin Expression: A Report with Anti-HER2 Therapy and Review of the Literature. Dent J (Basel) 2023; 11:229. [PMID: 37886914 PMCID: PMC10605875 DOI: 10.3390/dj11100229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 09/19/2023] [Accepted: 09/21/2023] [Indexed: 10/28/2023] Open
Abstract
Salivary duct carcinoma with rhabdoid features (SDC-RF) is a rare form of salivary gland neoplasm that was recently described. We report a case of SDC-RF of the parotid gland with loss of E-cadherin and decreased β-catenin expression in a 73-year-old male who presented with right facial/neck swelling and intermittent pain. Morphologically, the tumor presented with a discohesive infiltrate of isolated and cords of pleomorphic round cells containing moderate amount of eosinophilic to fine-vacuolated cytoplasm and hyperchromatic nuclei infiltrating through fibroadipose tissue and salivary parenchyma. Immunophenotypically, the tumor was positive for Cytokeratins Oscar and 7, GATA3, GCDFP, HER2, and an androgen receptor but negative for CK20, S100, p40, Melan A, CDX2, TTF1, ER, SATB2, DOG1, synaptophysin, and chromogranin. Due to its diffuse infiltrating pattern, involvement of the parapharyngeal space, supraclavicular fat pad, dermis, and skin without a defined surgical target, the tumor was deemed unresectable. Anti-HER2 therapy (Herceptin and Pertuzumab) was utilized. At the last follow-up, the patient is alive, with complete locoregional control and brain metastases. An electronic search was performed in the following registries for papers published up to June 2023: PubMed, Embase, and Web of Science. For the database searches, the keywords searched were "salivary gland", "salivary duct carcinoma", and "salivary duct carcinoma with rhabdoid features". Our review of the literature identified 30 cases of SDC-RF that reveal there is a predilection for males (83%), parotid gland (72%), and patients older than the 6th decade of life (83%). Immunophenotypically, all SDC-RF cases except one were positive for AR and GCDFP (97%), 81% were positive for HER2, and loss or decreased expression of E-cadherin in 93% of cases. In conclusion, we described a rare case of SDF-RF of the parotid gland with no E-cadherin expression, decreased β-catenin expression, and its immunophenotypic profile.
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Affiliation(s)
- Richa Jain
- Methodist Le Bonheur Healthcare, Memphis, TN 38104, USA
| | - E. Ritter Sansoni
- Department of Otolaryngology, College of Medicine, The University of Tennessee Health Science Center, Memphis, TN 38103, USA
| | - Jacqueline Angel
- Department of Radiology, College of Medicine, The University of Tennessee Health Science Center, Memphis, TN 38103, USA
| | - John P. Gleysteen
- Department of Otolaryngology, College of Medicine, The University of Tennessee Health Science Center, Memphis, TN 38103, USA
| | - D. Neil Hayes
- Department of Medicine, College of Medicine, The University of Tennessee Health Science Center, Memphis, TN 38103, USA
| | - Adepitan A. Owosho
- Department of Otolaryngology, College of Medicine, The University of Tennessee Health Science Center, Memphis, TN 38103, USA
- Department of Diagnostic Sciences, College of Dentistry, The University of Tennessee Health Science Center, Memphis, TN 38103, USA
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Wu YJ, Xiong J, Xiao GX, Tian Y, Yue JX, Cheng Q, Wang M, Zhou LQ, Zhou T. Salivary Duct Carcinoma Originated from the Inferior Turbinate: A Rare Case Report. EAR, NOSE & THROAT JOURNAL 2023:1455613231171832. [PMID: 37089112 DOI: 10.1177/01455613231171832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/25/2023] Open
Abstract
Salivary duct carcinoma (SDC) is an uncommon but highly aggressive tumor with a poor prognosis. SDC mainly arises from the major salivary glands, typically the parotid gland. Here, we report a rare case of sinonasal SDC in a 54-year-old male patient that might have originated from the inferior turbinate. The patient presented with left nasal congestion and rhinorrhea. Following an endoscopic intervention, the histopathological examination revealed a diagnosis of SDC, characterized by the formation of solid cancer nests and central comedo-type necrosis. Given the highly aggressive nature and unfavorable prognosis of SDC, it is essential to consider it as a differential diagnosis for unilateral nasal tumors.
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Affiliation(s)
- Ying-Jie Wu
- Department of Otorhinolaryngology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430022, China
| | - Jian Xiong
- Department of Otorhinolaryngology, People's Hospital of Dongxihu District, Wuhan, Hubei 430040, China
| | - Gui-Xiang Xiao
- Department of Pathology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yuan Tian
- Department of Geriatrics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Jian-Xin Yue
- Department of Otorhinolaryngology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430022, China
| | - Qing Cheng
- Department of Otorhinolaryngology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430022, China
| | - Miao Wang
- Department of Otorhinolaryngology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430022, China
| | - Liu-Qing Zhou
- Department of Otorhinolaryngology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430022, China
| | - Tao Zhou
- Department of Otorhinolaryngology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430022, China
- Hubei Province Key Laboratory of Molecular Imaging, Union Hospital, Wuhan 430022, China
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Identification of novel prognostic and predictive biomarkers in salivary duct carcinoma via comprehensive molecular profiling. NPJ Precis Oncol 2022; 6:82. [PMCID: PMC9636405 DOI: 10.1038/s41698-022-00324-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Accepted: 10/18/2022] [Indexed: 11/06/2022] Open
Abstract
AbstractMolecular targets and predictive biomarkers for prognosis in salivary duct carcinoma (SDC) have not been fully identified. We conducted comprehensive molecular profiling to discover novel biomarkers for SDC. A total of 67 SDC samples were examined with DNA sequencing of 464 genes and transcriptome analysis in combination with the clinicopathological characteristics of the individuals. Prognostic biomarkers associated with response to combined androgen blockade (CAB) treatment were explored using mRNA expression data from 27 cases. Oncogenic mutations in receptor tyrosine kinase (RTK) genes or genes in the MAPK pathway were identified in 55 cases (82.1%). Alterations in the phosphatidylinositol 3-kinase (PI3K)/AKT signaling pathway were identified in 38 cases (56.7%). Interestingly, patient prognosis could be predicted using mRNA expression profiles, but not genetic mutation profiles. The risk score generated from the expression data of a four-gene set that includes the ADAMTS1, DSC1, RNF39, and IGLL5 genes was a significant prognostic marker for overall survival in the cohort (HR = 5.99, 95% confidence interval (CI) = 2.73–13.1, p = 7.8 × 10−6). Another risk score constructed from the expression of CD3E and LDB3 was a strong prognostic marker for progression-free survival for CAB treatment (p = 0.03). Mutations in RTK genes, MAPK pathway genes, and PI3K/AKT pathway genes likely represent key mutations in SDC tumorigenesis. The gene expression profiles identified in this study may be useful for stratifying patients who are good candidates for CAB treatment and may benefit from additional systemic therapies.
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Saravakos P, Kourtidis S, Hartwein J, Preyer S. Parotid Gland Tumors: A Multicenter Analysis of 1020 Cases. Increasing Incidence of Warthin's Tumor. Indian J Otolaryngol Head Neck Surg 2022; 74:2033-2040. [PMID: 36452806 PMCID: PMC9702007 DOI: 10.1007/s12070-020-01981-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Accepted: 07/16/2020] [Indexed: 11/26/2022] Open
Abstract
We assessed the frequency of the parotid gland tumor entities and correlated sex and age in different tumor types. Retrospective data were obtained from three major otorhinolaryngology clinics in Karlsruhe and Pforzheim, Germany within a 10-year period. In total, 1020 cases of parotidectomy for benign and malignant lesions were identified. We found 864 (84.7%) and 156 (15.3%) patients with benign and malignant tumors of the parotid gland, respectively. The most common benign parotid tumor was Warthin's tumor, followed by pleomorphic adenoma. The most common primary malignant tumor types were acinic cell carcinoma and mucoepidermoid carcinoma. Secondary malignant tumors of the parotid gland included lymphoma and metastatic, cutaneous squamous cell carcinoma. The frequency of Warthin's tumors was higher than that of pleomorphic adenomas. A large proportion of the malignant parotid tumors represent metastases from squamous cell carcinoma of the skin of the head and neck.
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Affiliation(s)
- Panagiotis Saravakos
- Department of Otorhinolaryngology, Head and Neck Surgery, ViDia Christliche Kliniken Karlsruhe, Diakonissenstrasse 28, 76199 Karlsruhe, Germany
| | - Savvas Kourtidis
- Department of Otorhinolaryngology, Head and Neck Surgery, ViDia Christliche Kliniken Karlsruhe, Diakonissenstrasse 28, 76199 Karlsruhe, Germany
| | - Joerg Hartwein
- Department of Otorhinolaryngology, Head and Neck Surgery, Siloah St. Trudpert Klinikum, Wilferdinger Straße 67, 75179 Pforzheim, Germany
| | - Serena Preyer
- Department of Otorhinolaryngology, Head and Neck Surgery, ViDia Christliche Kliniken Karlsruhe, Diakonissenstrasse 28, 76199 Karlsruhe, Germany
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Targeted molecular profiling of salivary duct carcinoma with rhabdoid features highlights parallels to other apocrine and discohesive neoplasms: which phenotype should drive classification? Head Neck Pathol 2022; 16:1063-1072. [PMID: 35794510 PMCID: PMC9729655 DOI: 10.1007/s12105-022-01464-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Revised: 05/17/2022] [Accepted: 05/22/2022] [Indexed: 12/13/2022]
Abstract
BACKGROUND Salivary duct carcinoma with rhabdoid features (SDC-RF) is a recently-described salivary gland tumor that bears striking histologic similarity to lobular carcinoma of the breast. While this tumor has an apocrine phenotype that supports classification as a variant of SDC, it infrequently arises in association with conventional SDC. Furthermore, discohesive architecture can be seen in non-apocrine salivary carcinomas, raising the possibility that discohesive growth should define a separate entity. In this study, we aimed to perform comprehensive molecular profiling of SDC-RF to better understand its pathogenesis and classification. METHODS We documented the clinicopathologic features of 9 cases of SDC-RF and performed immunostains including AR, GCDFP, and e-cadherin on all cases. We also performed targeted next generation sequencing (NGS) panels on 7 cases that had sufficient tissue available. RESULTS The SDC-RF represented 8 men and 1 woman with a median age of 67 years (range 63-83 years) and included 6 parotid, 2 buccal, and 1 submandibular primary. All tumors were uniformly composed of discohesive cells with abundant eosinophilic cytoplasm; signet-ring cell features were seen in 2 cases. All tumors were also positive for AR (100%) and GCDFP (100%), and 7 tumors (78%) displayed lost or abnormal e-cadherin. NGS highlighted concomitant PIK3CA and HRAS mutations in 4 tumors, with additional cases harboring TP53, PTEN, and AKT1 mutations. Furthermore, CDH1 alterations were seen in 6 cases, including a novel CDH1::CORO7 fusion. Among 5 patients with follow-up available, 3 (60%) developed local recurrence and widespread distant metastasis and died of disease at a median 20 months (range 10-48 months). CONCLUSIONS Overall, our findings confirm frequent CDH1 mutations and e-cadherin inactivation in SDC-RF, similar to discohesive tumors from other sites. We also highlight an apocrine molecular profile similar to conventional SDC. However, occasional AKT1 mutation and signet-ring features suggest SDC-RF may also be related to mucinous adenocarcinoma. As more salivary tumors with discohesive growth are identified, it may become clearer whether SDC-RF should remain in the SDC family or be recognized as a separate entity.
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Imai T, Shinohara K, Uchino K, Okuma H, Maki F, Hiruma K, Ariizumi Y, Yamano Y. Paraneoplastic cerebellar degeneration with anti-Yo antibodies and an associated submandibular gland tumor: a case report. BMC Neurol 2022; 22:165. [PMID: 35501715 PMCID: PMC9059384 DOI: 10.1186/s12883-022-02684-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Accepted: 04/18/2022] [Indexed: 11/13/2022] Open
Abstract
Background As a debilitating syndrome, paraneoplastic cerebellar degeneration (PCD) remains challenging to treat. Further, anti-Yo antibody (directed against human cerebellar degeneration-related protein 2) detection in patients with PCD is associated with unsatisfactory responses to existing therapies. Here, we present the case of a 60-year-old woman who developed PCD with anti-Yo antibodies and a submandibular gland tumor. Case presentation A 60-year-old woman presented with a 5-day history of unsteadiness of gait and inadequate coordination of her extremities, along with truncal instability. Although walking without aid was possible, dysmetria of all four limbs, trunk, and gait ataxia was observed. While routine biochemical and hematological examinations were normal, the patient’s blood was positive for anti-Yo antibodies. When the neurological symptoms deteriorated despite administration of intravenous methylprednisolone, fluorodeoxyglucose-positron emission tomography (FDG-PET) and computed tomography (CT) images with contrast enhancement were performed, which showed a tumor in the left submaxillary gland. She underwent total left submandibular gland resection, including the tumor; histological and immunohistochemical results revealed a salivary duct carcinoma. She was administered intravenous methylprednisolone, followed by 10 plasma exchange sessions, intravenous immunoglobulins, and cyclophosphamide therapy. Following treatment, her symptoms were not alleviated, even after the reduction of anti-Yo titers. Conclusions Although tumor detection was delayed, early tumor detection, diagnosis, and PCD treatment are essential because any delay can result in the progression of the disorder and irreversible neurological damage. Therefore, we recommend that the possibility of a salivary gland tumor should be considered, and whole-body dual-modality CT, including the head and neck, and FDG-PET should be performed at the earliest for patients with well-characterized paraneoplastic antibodies when conventional imaging fails to identify a tumor.
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Affiliation(s)
- Takeshi Imai
- Department of Neurology, Kawasaki Municipal Tama Hospital: Kawasaki Shiritsu Tama Byoin, 1-30-37, Shukugawara Tama-ku Kawasaki-shi, Kawasaki, Kanagawa, Japan.
| | - Kensuke Shinohara
- Department of Neurology, Kawasaki Municipal Tama Hospital: Kawasaki Shiritsu Tama Byoin, 1-30-37, Shukugawara Tama-ku Kawasaki-shi, Kawasaki, Kanagawa, Japan
| | - Kenji Uchino
- Department of Neurology, Kawasaki Municipal Tama Hospital: Kawasaki Shiritsu Tama Byoin, 1-30-37, Shukugawara Tama-ku Kawasaki-shi, Kawasaki, Kanagawa, Japan
| | - Hirohisa Okuma
- Department of Neurology, Kawasaki Municipal Tama Hospital: Kawasaki Shiritsu Tama Byoin, 1-30-37, Shukugawara Tama-ku Kawasaki-shi, Kawasaki, Kanagawa, Japan
| | - Futaba Maki
- Department of Neurology, Shin Yurigaoka General Hospital: Shinyurigaoka Sogo Byoin, Kawasaki, Kanagawa, Japan
| | - Kiyoshi Hiruma
- Department of Otorhinolaryngology, Kawasaki Municipal Tama Hospital: Kawasaki Shiritsu Tama Byoin, Kawasaki, Kanagawa, Japan
| | - Yasushi Ariizumi
- Department of Diagnostic Pathology, St Marianna University School of Medicine Yokohama Seibu Hospital: Sei Marianna Ika Daigaku Yokohama-shi Seibu Byoin, Yokohama, Kanagawa, Japan
| | - Yoshihisa Yamano
- Department of Internal Medicine, Division of Neurology, St Marianna University School of Medicine: Sei Marianna Ika Daigaku, Kawasaki, Kanagawa, Japan
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Sivakumar N, Narwal A, Pandiar D, Devi A, Anand R, Bansal D, Kamboj M. Diagnostic utility of p63/p40 in the histologic differentiation of salivary gland tumors: A systematic review. Oral Surg Oral Med Oral Pathol Oral Radiol 2021; 133:189-198. [PMID: 34518135 DOI: 10.1016/j.oooo.2021.07.010] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Revised: 07/05/2021] [Accepted: 07/13/2021] [Indexed: 01/04/2023]
Abstract
OBJECTIVE Salivary gland tumors are a heterogeneous group of neoplasms with complex clinicopathologic behavior. These tumors often show an extremely diverse morphology and significant histologic patterns, making diagnosis a difficult task. Owing to the considerable differences in prognosis, treatment, and follow-up, accurately distinguishing these histologic mimickers is imperative. The aim of the present systematic review was to establish the diagnostic utility of p63/p40 immunostaining in histologic differentiation of salivary gland tumors. STUDY DESIGN An electronic search was carried out using MEDLINE by PubMed, Scopus, Google Scholar, Trip, Cochrane Library, and EMBASE databases. Articles in which both p63 and p40 immunohistochemical expressions were assessed were included for systematic review and their sensitivity and specificity were calculated. Risk of bias was analyzed for each study using the Quality Assessment of Diagnostic Accuracy Studies tool. RESULTS Ten eligible articles were included in the quantitative synthesis, which revealed a concordant positivity of p63 and p40 by nearly all cases of adenoid cystic carcinoma, pleomorphic adenoma, and mucoepidermoid carcinoma and most polymorphous adenocarcinomas showed discordant immunohistochemical expression (p63+/p40-). CONCLUSIONS The current evidence supports that integrated immunostaining of p63/p40 is a valuable adjunct for discerning enigmatic salivary gland tumors with true myoepithelial and/or squamous differentiation.
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Affiliation(s)
- N Sivakumar
- Junior Resident, Department of Oral Pathology and Microbiology, Post Graduate Institute of Dental Sciences, Rohtak, Haryana, India.
| | - Anjali Narwal
- Professor, Department of Oral Pathology and Microbiology, Post Graduate Institute of Dental Sciences, Rohtak, Haryana, India
| | - Deepak Pandiar
- Associate Professor, Department of Oral Pathology and Microbiology, Saveetha Dental College and Hospitals, Poonamallee High Road, Chennai, Tamil Nadu, India
| | - Anju Devi
- Associate Professor, Department of Oral Pathology and Microbiology, Post Graduate Institute of Dental Sciences, Rohtak, Haryana, India
| | - Rahul Anand
- Senior Resident, Department of Oral Pathology and Microbiology, Post Graduate Institute of Dental Sciences, Rohtak, Haryana, India
| | - Deepty Bansal
- Junior Resident, Department of Oral Pathology and Microbiology, Post Graduate Institute of Dental Sciences, Rohtak, Haryana, India
| | - Mala Kamboj
- Senior Professor and Head, Department of Oral Pathology and Microbiology, Post Graduate Institute of Dental Sciences, Rohtak, Haryana, India
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Rahman M, Griffith CC. Salivary Duct Carcinoma: An Aggressive Salivary Gland Carcinoma with Morphologic Variants, Newly Identified Molecular Characteristics, and Emerging Treatment Modalities. Surg Pathol Clin 2021; 14:111-126. [PMID: 33526216 DOI: 10.1016/j.path.2020.09.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Salivary duct carcinoma (SDC) is a rare, aggressive salivary gland malignancy with significant mortality. Morphologically, most tumors are characterized by apocrine differentiation with a typical immunophenotype of androgen receptor positive/gross cystic disease fluid protein positive/estrogen receptor negative/progesterone receptor negative. Several morphologic variants of SDC exist, representing diagnostic pitfalls. Several differential diagnoses should be considered because prognosis, treatment, and management may be different from SDC. For SDC, current treatment strategies are aggressive and commonly include surgical excision with lymph node dissection and adjuvant radiotherapy. Continued research is examining the utility of androgen deprivation therapy and targeted molecular therapy.
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Affiliation(s)
- Mobeen Rahman
- The Robert J. Tomsich Pathology and Laboratory Medicine Institute, Cleveland Clinic, Cleveland, OH, USA; Cleveland Clinic Head and Neck Pathology, Mail Code L25, 9500 Euclid Avenue, Cleveland, OH 44195, USA. https://twitter.com/ENT_path
| | - Christopher C Griffith
- The Robert J. Tomsich Pathology and Laboratory Medicine Institute, Cleveland Clinic, Cleveland, OH, USA; Cleveland Clinic Head and Neck Pathology, Mail Code L25, 9500 Euclid Avenue, Cleveland, OH 44195, USA.
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Combined androgen deprivation therapy in recurrent androgen-receptor-positive salivary duct carcinoma – a case report and review of the literature. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2020; 121:599-603. [DOI: 10.1016/j.jormas.2019.12.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Accepted: 12/27/2019] [Indexed: 12/12/2022]
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11
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Nakaguro M, Tada Y, Faquin WC, Sadow PM, Wirth LJ, Nagao T. Salivary duct carcinoma: Updates in histology, cytology, molecular biology, and treatment. Cancer Cytopathol 2020; 128:693-703. [PMID: 32421944 PMCID: PMC7541685 DOI: 10.1002/cncy.22288] [Citation(s) in RCA: 56] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Revised: 03/31/2020] [Accepted: 04/21/2020] [Indexed: 12/15/2022]
Abstract
Salivary duct carcinoma (SDC) is an aggressive subtype of primary salivary gland carcinoma, often with an advanced stage at presentation and high rates of metastasis and recurrence. It most commonly arises in the parotid gland of older men and microscopically resembles high-grade breast ductal carcinoma. While 50 years have lapsed since the first report of this entity, recent intensive studies have shed light on its biologic, genetic, and clinical characteristics. The diagnosis of SDC is aided by the immunohistochemical expression of androgen receptor (AR) coupled with its characteristic histomorphology. Fine-needle aspiration typically reveals cytologic features of high-grade carcinoma, and ancillary studies using cell block material can facilitate the specific diagnosis of SDC. In surgical specimens, certain histologic features are important prognostic factors, including nuclear pleomorphism, mitotic counts, vascular invasion, and the morphology at the invasion front. Several clinical studies have shown promising results using targeted therapy for AR and human epidermal growth factor receptor 2 (HER2), and the latest version of the National Comprehensive Cancer Network guidelines recommends the evaluation of AR and HER2 status before treatment. Recent molecular analyses have revealed multiple heterogeneous alterations in well-known oncogenes and tumor suppressor genes, including TP53, HRAS, PIK3CA, PTEN, and BRAF. Clinical trials of drugs targeting these genes may broaden the treatment options for SDC in the near future.
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Affiliation(s)
- Masato Nakaguro
- Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
- Department of Pathology and Laboratory Medicine, Nagoya University Hospital, Nagoya, Japan
| | - Yuichiro Tada
- Department of Head and Neck Oncology and Surgery, International University of Health and Welfare Mita Hospital, Tokyo, Japan
| | - William C. Faquin
- Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | - Peter M. Sadow
- Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | - Lori J. Wirth
- Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts
| | - Toshitaka Nagao
- Department of Anatomic Pathology, Tokyo Medical University, Tokyo, Japan
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12
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Prognostic Implication of Histopathologic Indicators in Salivary Duct Carcinoma: Proposal of a Novel Histologic Risk Stratification Model. Am J Surg Pathol 2020; 44:526-535. [PMID: 31764219 DOI: 10.1097/pas.0000000000001413] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Salivary duct carcinoma (SDC) is a rare, aggressive malignancy that histologically resembles high-grade mammary duct carcinoma. Because of the rarity of this entity, data verifying the association between histologic features and patient survival are limited. We conducted a comprehensive histologic review of 151 SDC cases and performed an analysis of the association between various histomorphologic parameters and the clinical outcome with the aim of developing a histologic risk stratification model that predicts the prognosis of SDC patients. A multivariate analysis revealed that prominent nuclear pleomorphism (overall survival [OS]: P=0.013; progression-free survival [PFS]: P=0.019), ≥30 mitoses/10 HPF (PFS: P=0.013), high tumor budding (OS: P=0.011; PFS: P<0.001), and high poorly differentiated clusters (OS: P<0.001; PFS: P<0.001) were independent prognostic factors. Patients with vascular invasion demonstrated a marginally significant association with shorter PFS (P=0.064) in a multivariate analysis. We proposed a 3-tier histologic risk stratification model based on the total number of positive factors among 4 prognostically relevant parameters (prominent nuclear pleomorphism, ≥30 mitoses/10 HPF, vascular invasion, and high poorly differentiated clusters). The OS and PFS of patients with low-risk (0 to 1 point) (23% of cases), intermediate-risk (2 to 3 points) (54% of cases), and high-risk (4 points) (23% of cases) tumors progressively deteriorated in this order (hazard ratio, 2.13 and 2.28, and 4.99 and 4.50, respectively; Ptrend<0.001). Our histologic risk stratification model could effectively predict patient survival and may be a useful aid to guide clinical decision-making in relation to the management of patients with SDC.
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Enomoto T, Aoki M, Miyagawa K, Matsumoto J, Kobayashi H, Takeuchi T, Abe H, Nonaka M, Sakata T, Inoue T, Nabeshima K. A Case of Salivary Duct Carcinoma Intracranial Invasion due to Perineural Invasion Through the Facial Nerve. World Neurosurg 2020; 140:332-337. [PMID: 32473330 DOI: 10.1016/j.wneu.2020.05.180] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Revised: 05/18/2020] [Accepted: 05/19/2020] [Indexed: 12/15/2022]
Abstract
BACKGROUND Salivary duct carcinoma (SDC) is a rare parotid tumor that often develops as a rapidly growing mass with a poor prognosis. It has a high rate of distant metastases, sometimes with infiltration along nerves. We describe a case of SDC that originated outside the cranium and extended into the cranium along the path of the facial nerve. CASE DESCRIPTION A 74-year-old man underwent magnetic resonance imaging at a local hospital, which revealed a tumor in the left internal acoustic canal; the patient was referred to our department. A left facial schwannoma was suspected, and magnetic resonance imaging was performed again 6 months later. Rapid tumor growth was confirmed, and the tumor was resected. The tumor displayed atypical epithelial cells with comedo necrosis and cribriform structure and was diagnosed as SDC. All residual intracranial tumors were removed using the middle fossa approach. The tumor, which was considered to be a primary tumor, was found near the stylomastoid foramen, and it was removed with the parotid gland. Five months after the initial surgery, metastasis to the trigeminal nerve was observed, and this was removed using a retrosigmoid approach, followed by radiation therapy. CONCLUSIONS All 4 surgical specimens of this case were presented, and the path of tumor progression was examined in detail. Although the primary lesion was small, intracranial invasion along the facial nerve occurred. SDC should be considered as a tumor that can extend into the cranium, even with a small primary lesion.
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Affiliation(s)
- Toshiyuki Enomoto
- Department of Neurosurgery, Faculty of Medicine Fukuoka University, Fukuoka, Japan
| | - Mikiko Aoki
- Department of Pathology, Faculty of Medicine Fukuoka University, Fukuoka, Japan.
| | - Ken Miyagawa
- Department of Neurosurgery, Faculty of Medicine Fukuoka University, Fukuoka, Japan
| | - Juntaro Matsumoto
- Department of Neurosurgery, Faculty of Medicine Fukuoka University, Fukuoka, Japan
| | - Hiromasa Kobayashi
- Department of Neurosurgery, Faculty of Medicine Fukuoka University, Fukuoka, Japan
| | - Toranoshin Takeuchi
- Department of Otolaryngology, Faculty of Medicine Fukuoka University, Fukuoka, Japan
| | - Hiroshi Abe
- Department of Neurosurgery, Faculty of Medicine Fukuoka University, Fukuoka, Japan
| | - Masani Nonaka
- Department of Neurosurgery, Faculty of Medicine Fukuoka University, Fukuoka, Japan
| | - Toshifumi Sakata
- Department of Otolaryngology, Faculty of Medicine Fukuoka University, Fukuoka, Japan
| | - Tooru Inoue
- Department of Neurosurgery, Faculty of Medicine Fukuoka University, Fukuoka, Japan
| | - Kazuki Nabeshima
- Department of Pathology, Faculty of Medicine Fukuoka University, Fukuoka, Japan
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14
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Gatta G, Guzzo M, Locati LD, McGurk M, Prott FJ. Major and minor salivary gland tumours. Crit Rev Oncol Hematol 2020; 152:102959. [PMID: 32485526 DOI: 10.1016/j.critrevonc.2020.102959] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Revised: 04/06/2020] [Accepted: 04/07/2020] [Indexed: 12/16/2022] Open
Abstract
Salivary glands carcinomas are very rare epithelial malignant tumors. In 2013 in Europe, 7800 new diagnoses were estimated, 8.5 % of all head and neck cancer. The last WHO classification (2017) counts more than 20 malignant histotypes, this variety as well as the rarity of some of them needs a skilled pathologist for diagnosis. Surgery remains the mainstay of management followed by radiation in high-grade and high-risk pathological features cases. The intensity modulated radiotherapy (IMRT) should be preferred over conformational radiotherapy techniques as adjuvant and exclusive treatment in advanced cases. Particle radiotherapy (i.e. protons, carbon ions) can have a role in advanced/unresectable disease since it was proved to have better results over photons in loco-regional control both in adenoid cystic carcinoma and in other histotypes. Although chemotherapy is still the most frequent treatment for metastatic patients, several new compounds (i.e. anti-angiogenic agents, tailored agents, checkpoint inhibitors) are under investigation.
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Affiliation(s)
- Gemma Gatta
- Fondazione IRCCS Istituto Nazionale dei Tumori, Milan Italy
| | - Marco Guzzo
- Fondazione IRCCS Istituto Nazionale dei Tumori, Milan Italy
| | - Laura D Locati
- Fondazione IRCCS Istituto Nazionale dei Tumori, Milan Italy.
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15
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Lee DS, Lee CG, Keum KC, Chung SY, Kim T, Wu HG, Kim JH, Sung MW, Ahn SH, Cho KH, Kang KM, Oh YT, Kim JH, Kang MK. Treatment outcomes of patients with salivary duct carcinoma undergoing surgery and postoperative radiotherapy. Acta Oncol 2020; 59:565-568. [PMID: 32085682 DOI: 10.1080/0284186x.2020.1730005] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Affiliation(s)
- Dong Soo Lee
- Department of Radiation Oncology, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Chang Geol Lee
- Department of Radiation Oncology, Yonsei University College of Medicine, Seoul, South Korea
| | - Ki Chang Keum
- Department of Radiation Oncology, Yonsei University College of Medicine, Seoul, South Korea
| | - Seung Yeun Chung
- Department of Radiation Oncology, Yonsei University College of Medicine, Seoul, South Korea
| | - Taehyung Kim
- Department of Radiation Oncology, Yonsei University College of Medicine, Seoul, South Korea
| | - Hong-Gyun Wu
- Department of Radiation Oncology, Seoul National University College of Medicine, Seoul, South Korea
- Cancer Research Institution, Seoul National University College of Medicine, Seoul, South Korea
- Institute of Radiation Medicine, Medical Research Center, Seoul National University, Seoul, South Korea
| | - Jin Ho Kim
- Department of Radiation Oncology, Seoul National University College of Medicine, Seoul, South Korea
| | - Myung-Whun Sung
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University College of Medicine, Seoul, South Korea
| | - Soon-Hyun Ahn
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University College of Medicine, Seoul, South Korea
| | - Kwan Ho Cho
- Proton Therapy Center, Research Institute and Hospital, National Cancer Center, Goyang, South Korea
| | - Ki Mun Kang
- Department of Radiation Oncology, Gyeongsang National University School of Medicine and Gyeongsang National University Changwon Hospital, Jinju, South Korea
| | - Young-Taek Oh
- Department of Radiation Oncology, Ajou University School of Medicine, Suwon, South Korea
| | - Jin Hee Kim
- Department of Radiation Oncology, Keimyung University, School of Medicine, Daegu, South Korea
| | - Min Kyu Kang
- Department of Radiation Oncology, School of Medicine, Kyungpook National University, Daegu, South Korea
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16
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Adeberg S, Windisch P, Ehret F, Baur M, Akbaba S, Held T, Bernhardt D, Haefner MF, Krauss J, Kargus S, Freudlsperger C, Plinkert P, Flechtenmacher C, Herfarth K, Debus J, Rieken S. Intensity Modulated Radiotherapy (IMRT) With Carbon Ion Boost in the Multimodal Treatment of Salivary Duct Carcinoma. Front Oncol 2019; 9:1420. [PMID: 31921675 PMCID: PMC6932999 DOI: 10.3389/fonc.2019.01420] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2019] [Accepted: 11/29/2019] [Indexed: 12/19/2022] Open
Abstract
Background: To assess outcomes and treatment related toxicity following intensity-modulated radiotherapy (IMRT) and a Carbon Ion Radiotherapy (CIRT) boost for salivary duct carcinoma (SDC). Methods: Twenty-eight consecutive patients with SDC who underwent a postoperative (82%) or definitive (18%) radiation therapy between 2010 and 2017 were assessed in this retrospective single-center analysis. CIRT boost was delivered with median 18 Gy(RBE) in 6 daily fractions, followed by an TomoTherapy®-based IMRT (median 54 Gy in 27 daily fractions). Treatment-related acute toxicity was assessed according to CTCAE Version 4. Results: Tumors were most commonly located in the major salivary glands (n = 25; 89%); 23 patients (82%) received previous surgery (R0: 30%; R1: 57%; R2: 4%; RX: 19%). Median follow-up was 30 months. Four patients (14%) experienced a local relapse and 3 (11%) developed locoregional recurrence. The two-year local control (LC) and locoregional control (LRC) was 96 and 93%, respectively. Median disease-free survival (DFS) was 27 months, metastasis-free survival (MFS) was 69 months, and overall survival (OS) was 93 months. Acute grade 3 toxicity occurred in 11 patients (mucositis, dermatitis, xerostomia; n = 2 each (7%) were the most common) and 2 osteonecroses of the mandibular (grade 3) occurred. No patients experienced grade ≥4 toxicities. Conclusions: Multimodal therapy approaches with surgery followed by IMRT and CIRT boost for SDC leads to good local and locoregional disease control. However, the frequent occurrence of distant metastases limits the prognosis and requires optimization of adjuvant systemic therapies.
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Affiliation(s)
- Sebastian Adeberg
- Department of Radiation Oncology, Heidelberg University Hospital, Heidelberg, Germany.,Heidelberg Institute for Radiation Oncology, Heidelberg, Germany.,Clinical Cooperation Unit Radiation Oncology, German Cancer Research Center (DKFZ), Heidelberg, Germany.,Heidelberg Ion-Beam Therapy Center, Heidelberg, Germany
| | - Paul Windisch
- Department of Radiation Oncology, Heidelberg University Hospital, Heidelberg, Germany
| | - Felix Ehret
- Department of Radiation Oncology, Heidelberg University Hospital, Heidelberg, Germany
| | - Melissa Baur
- Department of Radiation Oncology, Heidelberg University Hospital, Heidelberg, Germany
| | - Sati Akbaba
- Department of Radiation Oncology, Heidelberg University Hospital, Heidelberg, Germany.,Heidelberg Institute for Radiation Oncology, Heidelberg, Germany
| | - Thomas Held
- Department of Radiation Oncology, Heidelberg University Hospital, Heidelberg, Germany.,Heidelberg Institute for Radiation Oncology, Heidelberg, Germany
| | - Denise Bernhardt
- Department of Radiation Oncology, Heidelberg University Hospital, Heidelberg, Germany.,Heidelberg Institute for Radiation Oncology, Heidelberg, Germany
| | - Matthias F Haefner
- Department of Radiation Oncology, Heidelberg University Hospital, Heidelberg, Germany.,Heidelberg Institute for Radiation Oncology, Heidelberg, Germany
| | | | - Steffen Kargus
- Department of Oral and Maxillofacial Surgery, Heidelberg University Hospital, Heidelberg, Germany
| | - Christian Freudlsperger
- Department of Oral and Maxillofacial Surgery, Heidelberg University Hospital, Heidelberg, Germany
| | - Peter Plinkert
- Department of Otorhinolaryngology, Heidelberg University Hospital, Heidelberg, Germany
| | | | - Klaus Herfarth
- Department of Radiation Oncology, Heidelberg University Hospital, Heidelberg, Germany.,Heidelberg Institute for Radiation Oncology, Heidelberg, Germany.,Heidelberg Ion-Beam Therapy Center, Heidelberg, Germany
| | - Juergen Debus
- Department of Radiation Oncology, Heidelberg University Hospital, Heidelberg, Germany.,Heidelberg Institute for Radiation Oncology, Heidelberg, Germany.,Clinical Cooperation Unit Radiation Oncology, German Cancer Research Center (DKFZ), Heidelberg, Germany.,Heidelberg Ion-Beam Therapy Center, Heidelberg, Germany.,National Center for Tumor Diseases, Heidelberg, Germany
| | - Stefan Rieken
- Department of Radiation Oncology, Heidelberg University Hospital, Heidelberg, Germany.,Heidelberg Institute for Radiation Oncology, Heidelberg, Germany.,Heidelberg Ion-Beam Therapy Center, Heidelberg, Germany
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17
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Viscuse PV, Price KA, Garcia JJ, Schembri-Wismayer DJ, Chintakuntlawar AV. First Line Androgen Deprivation Therapy vs. Chemotherapy for Patients With Androgen Receptor Positive Recurrent or Metastatic Salivary Gland Carcinoma-A Retrospective Study. Front Oncol 2019; 9:701. [PMID: 31428578 PMCID: PMC6688187 DOI: 10.3389/fonc.2019.00701] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2019] [Accepted: 07/15/2019] [Indexed: 12/18/2022] Open
Abstract
Objectives: There is a lack of effective therapy for recurrent or metastatic salivary gland carcinoma. Androgen deprivation therapy has demonstrated efficacy in cases of salivary duct carcinoma (SDC) and high-grade adenocarcinoma not otherwise specified (NOS) that express androgen receptor. Materials and Methods: We conducted a single institution retrospective cohort study examining patients treated for recurrent/metastatic SDC or high-grade adenocarcinoma NOS of the salivary gland. Survival analyses were performed to assess for efficacy of first-line androgen deprivation therapy (ADT) vs. first-line conventional cytotoxic chemotherapy. Efficacy of salvage ADT was also assessed. Results: Fifty-eight patients were reviewed. Thirty-five patients had recurrent/metastatic disease of which 28 had SDC (80%) and 7 had high-grade adenocarcinoma NOS (20%). Median overall survival for first-line ADT was 25 months compared to 25 months for first-line chemotherapy [RR 0.54 (0.23–1.28, p = 0.16)]. Patients treated with first-line ADT had a response rate of 45% (9/20) and patients treated with first-line chemotherapy had a response rate of 14% (2/14). Six patients received salvage ADT with 1 patient demonstrating complete response and 3 with stable disease as best response (clinical benefit rate 67%). Conclusion: Overall survival for first line ADT and first line cytotoxic chemotherapy was comparable but response rates to first-line ADT were higher than those with first-line chemotherapy. Salvage ADT is active in recurrent/metastatic salivary gland carcinoma.
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Affiliation(s)
- Paul V Viscuse
- Department of Internal Medicine, Mayo Clinic, Rochester, MN, United States
| | - Katharine A Price
- Division of Medical Oncology, Mayo Clinic, Rochester, MN, United States
| | - Joaquin J Garcia
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, United States
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18
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Wong VM, Trageser EE, Luong RH. Pathology in Practice. J Am Vet Med Assoc 2019; 254:475-477. [PMID: 30714872 DOI: 10.2460/javma.254.4.475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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19
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Chidananda-Murthy G, Chandran J. Salivary Duct Carcinoma of Parotid Gland: a Rare Tumor. Indian J Surg Oncol 2018; 10:313-317. [PMID: 31168254 DOI: 10.1007/s13193-018-0853-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2018] [Accepted: 12/03/2018] [Indexed: 10/27/2022] Open
Affiliation(s)
| | - Jayanthi Chandran
- Department of Pathology, Sri Venkateshwaraa Medical College & Hospital, Puducherry, India
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20
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Villepelet A, Lefèvre M, Verillaud B, Janot F, Garrel R, Vergez S, Bertolus C, Malard O, de Gabory L, Mauvais O, Baujat B. Salivary duct carcinoma: Prospective multicenter study of 61 cases of the Réseau d'Expertise Français des Cancers ORL Rares. Head Neck 2018; 41:584-591. [PMID: 30421824 DOI: 10.1002/hed.25194] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2017] [Revised: 01/08/2018] [Accepted: 03/02/2018] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND The purposes of this study were to describe the characteristics of a prospective multicenter series of patients with salivary duct carcinoma and to investigate prognostic factors. METHODS Patients included for salivary duct carcinoma between 2009 and 2016 in the Réseau d'Expertise Français des Cancers ORL Rares (REFCOR) database were selected. Immunohistochemical analyses were performed. RESULTS Sixty-one patients were included in this study. The primary site was the parotid gland in 90% of the cases. Fifty-seven percent of the tumors were stage IV, 65% of patients had lymph node involvement, and 10% had metastases. Tumors showed androgen receptor (89%) and human epidermal growth factor receptor 2 (HER2)/neu (36%). Ninety-four percent of patients underwent surgery and 86% had postoperative radiotherapy. Six patients were treated with targeted therapies. The 3-year overall survival (OS) was 74% and the 3-year disease-free survival (DFS) was 44%. Tumor stages III to IV reduced DFS (hazard ratio [HR] 4.3; P = .04). The N2/3 class reduced distant metastasis-free survival (HR 7.3; P = .007). CONCLUSION Salivary duct carcinoma prognosis is poor and is correlated with tumor stage and lymph node classification. Androgen receptor and HER2/neu should be tested as they offer the possibility of targeted therapies.
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Affiliation(s)
- Aude Villepelet
- Service d'ORL et de Chirurgie Cervicofaciale, Hôpital Tenon, Assistance Publique-Hôpitaux de Paris, Paris / Université Pierre et Marie Curie, Paris, Paris, France
| | - Marine Lefèvre
- Service d'Anatomie Pathologique, Hôpital Tenon, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Benjamin Verillaud
- Service d'ORL et de Chirurgie Cervicofaciale, Hôpital Lariboisière, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - François Janot
- Département d'ORL et de Chirurgie Cervicofaciale, Institut Gustave-Roussy, Villejuif, Paris, France
| | - Renaud Garrel
- Service d'ORL et de Chirurgie Cervicofaciale, CHU de Montpellier, Paris, France
| | - Sébastien Vergez
- Service d'ORL et de Chirurgie Cervicofaciale, IUC Toulouse, Paris, France
| | - Chloé Bertolus
- Service de Chirurgie Maxillofaciale, Hôpital Pitié Salpétrière, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Olivier Malard
- Service d'ORL et de Chirurgie Cervicofaciale, CHU de Nantes, Paris, France
| | - Ludovic de Gabory
- Service d'ORL et de Chirurgie Cervicofaciale, CHU de Bordeaux, Paris, France
| | - Olivier Mauvais
- Service d'ORL et de Chirurgie Cervicofaciale, CHU de Besançon, Paris, France
| | - Bertrand Baujat
- Service d'ORL et de Chirurgie Cervicofaciale, Hôpital Tenon, Assistance Publique-Hôpitaux de Paris, Paris / Université Pierre et Marie Curie, Paris, Paris, France
| | -
- Réseau d'Expertise Français des Cancers ORL Rares: (REFCOR, French Rare Head and Neck Cancer Expert Network): S. Albert, G. Andry, E. Babin, C. Bach, J.-M. Badet, C. Badoual, A.C. Baglin, A. Banal, B. Barry, E. Baudin, B. Baujat, R.J. Bensadoun, C. Bertolus, J.-P. Bessède, D. Blanchard, C. Borel, A. Bozorg-Grayeli, R. Breheret, P. Breton, L. Brugel, G. Calais, O. Casiraghi, E. Cassagnau, L. Castillo, P. Ceruse, F. Chabolle, D. Chevalier, J.C. Chobaut, O. Choussy, A. Cosmidis, A. Coste, V. Costes, L. Crampette, V. Darrouzet, P. Demez, P. Dessi, B. Devauchelle, G. Dolivet, F. Dubrulle, S. Duflo, X. Dufour, S. Faivre, N. Fakhry, C. Ferron, F. Floret, L. de Gabory, R. Garrel, L. Geoffrois, L. Gilain, A. Giovanni, A. Girod, B. Guerrier, S. Hans, P. Herman, P. Hofman, M. Housset, R. Jankowski, F. Jegoux, M. Juliéron, M.-C. Kaminsky, F. Kolb, J. Lacau St Guily, L. Laccoureye, B. Lallemant, P. Lang, E. Lartigau, J.-P. Lavieille, M. Lefevre, X. Leroy, O. Malard, F. Massip, O. Mauvais, J.-C. Merol, J. Michel, T. Mom, S. Morinière, E. de Monès, G. Moulin, G. Noel, G. Poissonnet, J.-M. Prades, D. de Raucourt, E. Reyt, C. Righini, Y. Marie Robin, F. Rolland, B. Ruhin, N. Sarroul, P. Schultz, E. Serrano, O. Sterkers, V. Strunski, A. Sudaka, M. Tassart, S. Testelin, J. Thariat, A. Timochenko, B. Toussaint, E. Uro Coste, G. Valette, T. Van den Abbeele, A. Varoquaux, F. Veillon, S. Vergez, M. Wassef
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21
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Abstract
PURPOSE OF REVIEW The review puts new information on geno- and phenotype of salivary duct carcinoma (SDC) in the perspective of the updated 2017 WHO classification. RECENT FINDINGS The proportion of SDC is increasing. This may be because of a true rise in incidence, but certainly to better diagnostic tests and changed WHO definitions. In this light, a substantial proportion of carcinoma expleomorphic adenoma is now attributed to the category of SDC. 'Low-grade SDC' and 'SDC in-situ' of the former WHO classification, are now named low-grade and high-grade intraductal carcinoma (IDC), respectively. Recent series quantify biologic aggressiveness: perineural growth, vascular invasion, and extracapsular extension in lymph node metastasis are each observed in two out of three patients with SDC. Most patients die within 3 years, but once 5-year disease-free survival is reached, further disease activity is exceptional. The typical molecular biological profile with high human epidermal growth factor receptor 2 and androgen receptor expression is increasingly successfully exploited in clinical trials for advanced SDC. SUMMARY The aggressive SDC is increasingly diagnosed. Despite intensive combined surgery and radiation therapy, many patients recur, for whom new bullets, targeting the molecular biological mechanisms, are the subject of ongoing clinical trials.
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22
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Anwer AW, Faisal M, Adeel M, Waqas O, Abu Bakar M, Qadeer S, Koukab M, Hussain R, Jamshed A. Clinicopathological Behavior and Treatment-related Outcome of Rare Salivary Duct Carcinoma: The Shaukat Khanum Memorial Cancer Hospital Experience. Cureus 2018; 10:e3139. [PMID: 30345196 PMCID: PMC6188220 DOI: 10.7759/cureus.3139] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Background Salivary gland tumors are rare salivary gland malignancies with resemblance to ductal breast carcinoma. We have described clinicopathological behavior and treatment outcomes of this rare malignancy. Methods Salivary duct carcinoma patients treated from 2010 to 2015 were retrospectively analyzed for clinicopathological characteristics and treatment-related outcomes of the disease. Results A total of 12 patients with salivary duct carcinoma were included in the study. All were males with mean age of 52.58 ± 13.43. Parotid gland was the most commonly involved major salivary gland while buccal mucosa and anterior tongue were most common oral cavity sub-sites involving minor salivary glands. The disease-free survival was 75% at 10 months and 25% at 20 months. The mean follow-up time was 12 months. There were three local recurrences and one distant metastasis. Conclusion Salivary duct carcinoma is a locally aggressive tumor with tendency for local recurrence and distant metastasis. Adverse features such as perineural invasion, extra-capsular spread and advanced nodal disease may worsen prognosis.
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Affiliation(s)
- Abdul Wahid Anwer
- Department of Surgical Oncology, Shaukat Khanum Memorial Cancer Hospital and Research Center, Lahore, Pakistan, Lahore, PAK
| | - Muhammad Faisal
- Department of Surgical Oncology, Shaukat Khanum Memorial Cancer Hospital and Research Center, Lahore, PAK
| | - Mohammad Adeel
- Department of Surgical Oncology, Shaukat Khanum Memorial Cancer Hospital and Research Center, Lahore, Pakistan
| | - Omer Waqas
- Pathology, Shaukat Khanum Memorial Cancer Hospital and Research Center, Lahore, PAK
| | - Muhammad Abu Bakar
- Biostatistician and Cancer Epidemiologist, Shaukat Khanum Memorial Cancer Hospital and Research Center, Lahore, PAK
| | - Saman Qadeer
- Surgical Oncology, Shaukat Khanum Memorial Cancer Hospital and Research Center, Lahore, PAK
| | - Maliha Koukab
- Department of Surgical Oncology, Shaukat Khanum Memorial Cancer Hospital and Research Center, Lahore, PAK
| | - Raza Hussain
- Department of Surgical Oncology, Shaukat Khanum Memorial Cancer Hospital and Research Center, Lahore, PAK
| | - Arif Jamshed
- Department of Radiation Oncology, Shaukat Khanum Memorial Cancer Hospital and Research Center, Lahore, PAK
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Nakaguro M, Urano M, Suzuki H, Yamada K, Sakaguchi A, Ogura K, Matsumoto T, Ono N, Asato T, Mikami Y, Imai H, Nagao T. Low-grade intraductal carcinoma of the salivary gland with prominent oncocytic change: a newly described variant. Histopathology 2018; 73:314-320. [DOI: 10.1111/his.13517] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2017] [Revised: 03/06/2018] [Accepted: 03/12/2018] [Indexed: 01/29/2023]
Affiliation(s)
- Masato Nakaguro
- Department of Pathology and Laboratory Medicine; Nagoya University Hospital; Nagoya Japan
| | - Makoto Urano
- Department of Diagnostic Pathology; Fujita Health University, School of Medicine; Toyoake Japan
| | - Hiroaki Suzuki
- Department of Diagnostic Pathology; National Hospital Organisation Hokkaido Cancer Center; Sapporo Japan
| | - Kazuyuki Yamada
- Department of Head and Neck Surgery; National Hospital Organisation Hokkaido Cancer Center; Sapporo Japan
| | - Asumi Sakaguchi
- Department of Diagnostic Pathology; Juntendo University Nerima Hospital; Tokyo Japan
| | - Kanako Ogura
- Department of Diagnostic Pathology; Juntendo University Nerima Hospital; Tokyo Japan
| | - Toshiharu Matsumoto
- Department of Diagnostic Pathology; Juntendo University Nerima Hospital; Tokyo Japan
| | - Noritsugu Ono
- Department of Otorhinolaryngology; Juntendo University Nerima Hospital; Tokyo Japan
| | - Tsuguharu Asato
- Department of Diagnostic Pathology; Kumamoto University Hospital; Kumamoto Japan
| | - Yoshiki Mikami
- Department of Diagnostic Pathology; Kumamoto University Hospital; Kumamoto Japan
| | - Hiroshi Imai
- Pathology Division; Mie University Hospital; Tsu Mie Japan
| | - Toshitaka Nagao
- Department of Anatomic Pathology; Tokyo Medical University; Tokyo Japan
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24
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Kawakita D, Tada Y, Imanishi Y, Beppu S, Tsukahara K, Kano S, Ozawa H, Okami K, Sato Y, Shimizu A, Sato Y, Fushimi C, Takase S, Okada T, Sato H, Otsuka K, Watanabe Y, Sakai A, Ebisumoto K, Togashi T, Ueki Y, Ota H, Shimura T, Hanazawa T, Murakami S, Nagao T. Impact of hematological inflammatory markers on clinical outcome in patients with salivary duct carcinoma: a multi-institutional study in Japan. Oncotarget 2018; 8:1083-1091. [PMID: 27894101 PMCID: PMC5352036 DOI: 10.18632/oncotarget.13565] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2016] [Accepted: 11/09/2016] [Indexed: 12/17/2022] Open
Abstract
The prognostic role of modified Glasgow Prognostic Score (mGPS), neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) in patients with salivary duct carcinoma (SDC) remains unclear. We conducted a multi-institutional retrospective cohort study of 140 SDC patients. The survival impact of these hematological markers was evaluated using multivariate proportional hazard models.High mGPS (≥1) was significantly associated with worse survival (3-year overall survival (OS): 16.7% vs 66.1%, p-value=0.003; 3-year progression-free survival (PFS): 0.0% vs 27.9%, p-value<0.001). Additionally, high C-reactive protein (CRP) (≥0.39 mg/dl) was significantly associated with worse survival (3-year OS: 32.1% vs 68.2%, p-value=0.001; 3-year PFS: 7.1% vs 31.1%, p-value<0.001). These associations were consistent with multivariate analysis adjusted for established prognostic factors. Although we also found significant association of high NLR (≥2.5) with OS (HR 1.80; 95% confidence interval, 1.05-3.08) in multivariate analysis, this association were inconsistent with the results of PFS. In addition, we found no significant associations of PLR with survival. In conclusion, we found that mGPS, CRP and NLR were identified as prognostic factors associated with survival in SDC patients.
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Affiliation(s)
- Daisuke Kawakita
- Department of Otorhinolaryngology, Head and Neck Surgery, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Yuichiro Tada
- Department of Head and Neck Oncology and Surgery, International University of Health and Welfare Mita Hospital, Tokyo, Japan
| | - Yorihisa Imanishi
- Department of Otorhinolaryngology-Head and Neck Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Shintaro Beppu
- Department of Otorhinolaryngology, Head and Neck Surgery, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Kiyoaki Tsukahara
- Department of Otolaryngology, Tokyo Medical University School of Medicine, Tokyo, Japan
| | - Satoshi Kano
- Department of Otorhinolaryngology-Head and Neck Surgery, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Hiroyuki Ozawa
- Department of Otorhinolaryngology-Head and Neck Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Kenji Okami
- Department of Otolaryngology-Head and Neck Surgery, Tokai University School of Medicine, Isehara, Japan
| | - Yuichiro Sato
- Department of Head and Neck Surgery, Niigata Cancer Center Hospital, Niigata, Japan
| | - Akira Shimizu
- Department of Otolaryngology, Tokyo Medical University School of Medicine, Tokyo, Japan
| | - Yukiko Sato
- Department of Pathology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Chihiro Fushimi
- Department of Head and Neck Oncology and Surgery, International University of Health and Welfare Mita Hospital, Tokyo, Japan
| | - Soichiro Takase
- Department of Otolaryngology, Tokyo Medical University School of Medicine, Tokyo, Japan
| | - Takuro Okada
- Department of Head and Neck Oncology and Surgery, International University of Health and Welfare Mita Hospital, Tokyo, Japan
| | - Hiroki Sato
- Department of Otolaryngology, Tokyo Medical University School of Medicine, Tokyo, Japan
| | - Kuninori Otsuka
- Department of Otorhinolaryngology-Head and Neck Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Yoshihiro Watanabe
- Department of Otorhinolaryngology-Head and Neck Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Akihiro Sakai
- Department of Otolaryngology-Head and Neck Surgery, Tokai University School of Medicine, Isehara, Japan
| | - Koji Ebisumoto
- Department of Otolaryngology-Head and Neck Surgery, Tokai University School of Medicine, Isehara, Japan
| | - Takafumi Togashi
- Department of Head and Neck Surgery, Niigata Cancer Center Hospital, Niigata, Japan
| | - Yushi Ueki
- Department of Head and Neck Surgery, Niigata Cancer Center Hospital, Niigata, Japan
| | - Hisayuki Ota
- Department of Head and Neck Surgery, Niigata Cancer Center Hospital, Niigata, Japan
| | - Tomotaka Shimura
- Department of Anatomic Pathology, Tokyo Medical University School of Medicine, Tokyo, Japan
| | - Toyoyuki Hanazawa
- Department of Otolaryngology, Head and Neck Surgery, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Shingo Murakami
- Department of Otorhinolaryngology, Head and Neck Surgery, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Toshitaka Nagao
- Department of Anatomic Pathology, Tokyo Medical University School of Medicine, Tokyo, Japan
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Wick MR. Primary lesions that may imitate metastatic tumors histologically: A selective review. Semin Diagn Pathol 2018; 35:123-142. [DOI: 10.1053/j.semdp.2017.11.010] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
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Schmitt NC, Kang H, Sharma A. Salivary duct carcinoma: An aggressive salivary gland malignancy with opportunities for targeted therapy. Oral Oncol 2017; 74:40-48. [PMID: 29103750 PMCID: PMC5685667 DOI: 10.1016/j.oraloncology.2017.09.008] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2017] [Revised: 08/16/2017] [Accepted: 09/12/2017] [Indexed: 12/15/2022]
Abstract
Salivary duct carcinoma (SDC) is a rare, aggressive salivary malignancy that is often diagnosed at an advanced stage. Previously, little was known about outcomes of this disease due to its rarity. In the past several years, much has been learned about salivary duct carcinoma after publication of outcomes from several large single-institution series and national database searches. Recent studies of genomic alterations have helped elucidate the biology and pathogenesis of this aggressive disease. Here we review outcomes of the disease, effects of treatment, prognostic factors, and genomic alterations in SDC. Studies of targeted therapy and promising future directions are also discussed.
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Affiliation(s)
- Nicole C Schmitt
- Integrative Therapeutics Program, National Institute on Deafness and Other Communication Disorders, National Institutes of Health, Bethesda, MD, United States; Department of Otolaryngology - Head and Neck Surgery, Johns Hopkins University, Bethesda, MD, United States.
| | - Hyunseok Kang
- Department of Oncology, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins Medical Institutions, Baltimore, MD, United States
| | - Arun Sharma
- Division of Otolaryngology - Head and Neck Surgery, Southern Illinois University, Springfield, IL, United States
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Vallabh N, Srinivasan V, Hughes D, Agbamu D. Salivary duct carcinoma arising from the inferior turbinate. J Surg Case Rep 2017; 2017:rjx090. [PMID: 28775834 PMCID: PMC5534007 DOI: 10.1093/jscr/rjx090] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2017] [Accepted: 07/11/2017] [Indexed: 02/03/2023] Open
Abstract
Salivary duct carcinoma (SDC) is an uncommon, aggressive tumour, which carries a poor prognosis. SDC affects the major salivary glands, usually occurring in the parotid gland. A 76-year-old male patient presented with right-sided nasal obstruction and rhinorrhoea. A polypoidal mass was seen in the right inferior turbinate mimicking a benign neoplasm. Histological examination following wide excision led to a diagnosis of SDC. There are no therapeutic guidelines and management is based on experience with SDC of the major salivary glands. Given the aggressive nature and poor prognosis of the disease, it is a rare but important differential to consider in patients with unilateral nasal mass.
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Affiliation(s)
- Nimisha Vallabh
- Ear, Nose and Throat Department, Wirral Teaching Hospitals NHS Trust, Arrowe Park Hospital, Wirral CH49 5PE, UK
| | - Venkat Srinivasan
- Ear, Nose and Throat Department, Wirral Teaching Hospitals NHS Trust, Arrowe Park Hospital, Wirral CH49 5PE, UK
| | - David Hughes
- Radiology Department, Wirral Teaching Hospitals NHS Trust, Arrowe Park Hospital, Wirral CH49 5PE, UK
| | - David Agbamu
- Histopatholgy Department, Wirral Teaching Hospitals NHS Trust, Arrowe Park Hospital, Wirral CH49 5PE, UK
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28
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Rahimi S, Bradley KL, Akaev I, Marani C, Yeoh CC, Brennan PA. Androgen Receptor Expression in Primary Nonsquamous Cell Rare-Variant Carcinomas of the Head and Neck. OTO Open 2017; 1:2473974X17715633. [PMID: 30480186 PMCID: PMC6239020 DOI: 10.1177/2473974x17715633] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2017] [Revised: 04/26/2017] [Accepted: 05/26/2017] [Indexed: 11/16/2022] Open
Abstract
Objective Androgen receptor (AR) is a diagnostic immunohistochemical marker for
salivary gland duct carcinoma (SDC), but other nonsquamous cell head and
neck carcinomas (NSCCs) may also express it. The aim of this preliminary
study was to investigate the immunohistochemical expression of AR in rare
head and neck NSCCs. Study Design Retrospective analysis of histologic records. Setting A large community hospital. Subjects and Methods Twenty-seven patients with NSCC were selected (21 men, 6 women; average age,
69 years). Exclusion criteria were histologically confirmed primary and
metastatic head and neck squamous cell carcinomas and thyroid carcinomas. AR
immunohistochemistry was done on formalin-fixed, paraffin-embedded tissue
blocks. Results Variable AR expression was found in 5 of 27 (25%) cases of NSCC. All 7
patients with SDC showed intense and extensive positive immunoreactivity. Of
27 NSCC tumors, 15 (56%) had negative staining. Conclusion In the head and neck, expression of AR is not limited to SDCs; other NSCCs
also express it. When surgery or radiotherapy is not appropriate for
recurrent or metastatic head and neck NSCC, palliative chemotherapy offers
poor results. Antiandrogen therapy is well tolerated and is much less toxic
than chemotherapy. Since androgen deprivation therapy has been used against
SDCs, this therapy may theoretically be used in a small subset of head and
neck NSCCs.
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Affiliation(s)
- Siavash Rahimi
- Pathology Centre-Histopathology, Queen Alexandra Hospital, Portsmouth, UK.,School of Pharmacy and Biomedical Sciences, University of Portsmouth, Portsmouth, UK
| | | | - Iolia Akaev
- School of Pharmacy and Biomedical Sciences, University of Portsmouth, Portsmouth, UK
| | - Carla Marani
- Division of Histopathology, San Carlo Hospital, Rome, Italy
| | - Chit Cheng Yeoh
- Department of Oncology, Queen Alexandra Hospital, Portsmouth, UK
| | - Peter A Brennan
- Department of Oral and Maxillofacial Surgery, Queen Alexandra Hospital, Portsmouth, UK
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Characterization, treatment and outcomes of salivary ductal carcinoma using the National Cancer Database. Oral Oncol 2017; 71:41-46. [PMID: 28688689 DOI: 10.1016/j.oraloncology.2017.05.005] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2016] [Revised: 03/16/2017] [Accepted: 05/10/2017] [Indexed: 11/23/2022]
Abstract
OBJECTIVES To analyze clinical, treatment and outcome data for patients with salivary ductal carcinoma in a large population-based sample. MATERIALS AND METHODS The National Cancer Database was queried to identify patients diagnosed with salivary ductal carcinoma between 2004 and 2013. Kaplan Meier and Cox regression analysis were used to assess overall survival (OS) and identify impact of specific variables on OS. RESULTS A total of 495 patients were identified. The most common site of tumor origin was the parotid (80%). 130 patients (26.3%) presented with early stage (I-II) disease, 257 patients (51.9%) with locoregionally advanced pathologic stage (III-IVB) disease and 41 patients (8.3%) with metastatic disease. The 5year OS for these patients was 79.5%, 40.4% and 0% respectively. At presentation, 46.6% had node positive disease. Surgery was performed in 100% of patients with early stage disease, 98.4% with advanced disease and 90.2% with metastatic disease. Radiation therapy, generally postoperative radiation, was given to 58.5% of patients with stage I-II disease, 71.6% with stage III-IVB disease and 53.7% with metastatic disease. Chemotherapy was utilized in 5.4% of patients with stage I-II disease, 35% with stage III-IVB and 70.7% with metastatic disease. On multivariable analysis, there were no significant differences in OS based on receipt of adjuvant radiotherapy, chemotherapy, or chemoradiotherapy. CONCLUSION Salivary ductal carcinoma represents an uncommon and aggressive subset of salivary tumors for which current adjuvant treatments do not have a detectable impact on overall survival.
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30
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Noda K, Hirano T, Okamoto T, Suzuki M. Primary salivary duct carcinoma arising from the Stensen duct. EAR, NOSE & THROAT JOURNAL 2017; 95:E15-7. [PMID: 27657321 DOI: 10.1177/014556131609500907] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
This report describes a salivary duct carcinoma (SDC) arising from the extraglandular portion of the Stensen duct. The patient was a 56-year-old man who presented with a palpable, elastic, hard mass without tenderness in the right cheek. Computed tomography revealed a tumor of the extraglandular portion of the Stensen duct. Supraomohyoid right neck dissection and total right parotidectomy were performed, and the histologic diagnosis was SDC of the Stensen duct. Postoperatively, the patient received no additional treatment. Neither recurrence nor metastasis was observed during 4 years of follow-up examination. SDC of the Stensen duct is extremely rare. To our knowledge, there is no report that describes primary SDC arising from that location. We also believe this is the first report that describes the clinical course of primary SDC arising from a Stensen duct.
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Affiliation(s)
- Kenji Noda
- Department of Otolaryngology, Oita University, Idaigaoka hasama-machi, Yufu, Oita, Japan 879-5593.
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Thorpe LM, Schrock AB, Erlich RL, Miller VA, Knost J, Le-Lindqwister N, Jujjavarapu S, Ali SM, Liu JJ. Significant and durable clinical benefit from trastuzumab in 2 patients with HER2-amplified salivary gland cancer and a review of the literature. Head Neck 2016; 39:E40-E44. [PMID: 28006087 DOI: 10.1002/hed.24634] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2016] [Accepted: 10/12/2016] [Indexed: 01/30/2023] Open
Abstract
BACKGROUND Salivary ductal carcinoma and carcinoma ex pleomorphic adenoma (CEPA) are aggressive salivary gland cancers with poor prognosis. The standard of care is resection with or without radiotherapy, and there are no established systemic therapy options. METHODS We describe 1 patient with metastatic CEPA and 1 patient with metastatic recurrent salivary duct carcinoma whose tumors were evaluated by comprehensive genomic profiling. Testing identified human epidermal growth factor receptor 2 (HER2) amplification in both patients, and an additional activating HER2 mutation in the CEPA case. RESULTS Both patients were treated with the HER2-targeting monoclonal antibody trastuzumab (herceptin) plus chemotherapy and experienced rapid responses. Subsequently, both patients were given single-agent maintenance trastuzumab and continue to experience durable disease control. CONCLUSION Given the poor prognosis for salivary gland cancers and the limited treatment options upon recurrence or metastasis, patients should be tested for all classes of HER2 alterations. In cases with HER2 overexpression or activation, targeted therapies, such as trastuzumab are promising. © 2016 Wiley Periodicals, Inc. Head Neck 39: E40-E44, 2017.
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Affiliation(s)
| | | | | | | | | | | | | | - Siraj M Ali
- Foundation Medicine Inc, Cambridge, Massachusetts
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32
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Di Palma S, Simpson RHW, Marchiò C, Skálová A, Ungari M, Sandison A, Whitaker S, Parry S, Reis-Filho JS. Salivary duct carcinomas can be classified into luminal androgen receptor-positive, HER2 and basal-like phenotypes. Histopathology 2016; 61:629-43. [PMID: 22882517 DOI: 10.1111/j.1365-2559.2012.04252.x] [Citation(s) in RCA: 78] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
AIMS The aim of this study was to devise a molecular classification for salivary duct carcinomas (SDCs) based on the similarities between SDCs and breast carcinomas and on characteristics of the microarray-based gene expression profiling-defined molecular subtypes of breast cancer. METHODS AND RESULTS Forty-two pure salivary duct carcinomas, 35 of which contained an in-situ component as defined by histological review and/or immunohistochemical analysis, were stained with antibodies for oestrogen receptor (ER), progesterone receptor (PR), androgen receptor (AR), human epidermal growth factor receptor 2 (HER2), epidermal growth factor receptor (EGFR) and cytokeratin (CK) 5/6. Based on these markers, tumours were classified into HER2, luminal androgen receptor-positive, basal-like, luminal and indeterminate phenotype. Analysis revealed that 16.7%, 69%, 4.8%, 9.5% and 0% were of HER2, luminal androgen receptor-positive, basal-like, indeterminate and luminal phenotype, respectively. The in-situ and invasive components displayed the same molecular subtype in all but one case. CONCLUSION Salivary duct carcinomas can be classified into molecular subgroups approximately equivalent to those in the breast. We also report on the existence of a subgroup of bona fide pure salivary duct carcinomas that have a 'basal-like' phenotype. Understanding the phenotypic complexity of SDCs may help to expedite the identification of novel therapeutic targets for these aggressive tumours.
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Affiliation(s)
- Silvana Di Palma
- Department of Histopathology, Royal Surrey County Hospital, Guildford, SurreyDivision of Clinical Medicine, University of Surrey, Guildford, SurreyDepartment of Histopathology, Royal Devon and Exeter Hospital, Exeter, DevonThe Breakthrough Breast Cancer Research Centre - Institute of Cancer Research, London, UKDepartment of Pathology, Faculty of Medicine, Charles University in Prague, Plzeň, Czech RepublicDepartment of Pathology, Spedali Civili Brescia, Brescia, ItalyDepartment of Histopathology, Imperial College Healthcare Trust, Charing Cross Hospital, LondonDepartment of Oncology, St Lukes Cancer Centre, Royal Surrey County Hospital, Guildford, Surrey, UK
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Invasive micropapillary salivary duct carcinoma mixed with mucin-rich salivary duct carcinoma in minor salivary gland: a rare case report. Oral Surg Oral Med Oral Pathol Oral Radiol 2016; 121:e162-7. [DOI: 10.1016/j.oooo.2015.10.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2015] [Revised: 09/08/2015] [Accepted: 10/11/2015] [Indexed: 11/22/2022]
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Al-Qahtani KH, Tunio MA, Bayoumi Y, Gurusamy VM, Bahamdain FAA, Fatani H. Clinicopathological features and treatment outcomes of the rare, salivary duct carcinoma of parotid gland. J Otolaryngol Head Neck Surg 2016; 45:32. [PMID: 27184361 PMCID: PMC4867527 DOI: 10.1186/s40463-016-0146-2] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2016] [Accepted: 05/11/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Salivary ductal carcinoma (SDC) of parotid gland is a rare and aggressive entity; accounting for 1-3 % of all malignant salivary gland tumors, 0.2 % of epithelial salivary gland neoplasms, 0.5 % of salivary gland carcinomas, and 1.1 % of parotid gland carcinomas. Here in we aimed to evaluate the clinico-pathological features and treatment outcomes of parotid gland SDC in Saudi population. METHODS Among 38 patients with parotid malignancies, who were treated in two major tertiary care referral cancer centers between December 2007 and December 2014, seven cases (18.4 %) were found to have SDC, which were investigated for clinicopathological features, locoregional recurrences (LRRs), distant metastasis (DM) and survival rates. RESULTS Mean age of cohort was 62.3 years (range: 41-83) and female predominant (71.4 %). All patients underwent total parotidectomy and ipsilateral neck dissection. Mean tumor size was 3.4 cm (range: 2.1-5.3); perineural invasion (85.8 %); lymph node involvement (42.9 %); and HER-2 neu overexpression (28.6 %). Postoperative radiation therapy (PORT) was given to six patients (dose: 50-66 Gy). Median follow-up was 20.2 months (range: 11-48). LRRs were seen in five (71.4 %) patients (base of skull, 3 patients; cervical nodes, one patient; parotid bed, one patient). LRRs were salvaged with resection (two patients) and re-irradiation (one patient with base of skull). DM in lungs was seen in three patients (42.8 %); one treated with carboplatin/paclitaxel based chemotherapy. The 4-year disease free and overall survival rates were 16.7 % and 40 % respectively. CONCLUSION SDC of parotid gland is a rare and aggressive entity, and most of LRRs were seen in the base of skull, which warrants inclusion of base of skull in clinical target volume in PORT planning. Role of anti HER-2 targeted therapy in SDC with HER-2 neu overexpression needs further investigations.
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Affiliation(s)
- Khalid Hussain Al-Qahtani
- Department of Otolaryngology-Head & Neck Surgery, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Mutahir A Tunio
- Radiation Oncology, King Fahad Medical City, Riyadh, 59046, Saudi Arabia.
| | | | | | | | - Hanadi Fatani
- Histopathology, Comprehensive Cancer Center, King Fahad Medical City, Riyadh, 59046, Saudi Arabia
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35
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Mukaigawa T, Hayashi R, Hashimoto K, Ugumori T, Hato N, Fujii S. Programmed death ligand-1 expression is associated with poor disease free survival in salivary gland carcinomas. J Surg Oncol 2016; 114:36-43. [PMID: 27111278 DOI: 10.1002/jso.24266] [Citation(s) in RCA: 76] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2015] [Accepted: 04/02/2016] [Indexed: 12/31/2022]
Abstract
BACKGROUND AND OBJECTIVES The immune checkpoint ligand programmed death ligand-1 (PD-L1) is expressed in various carcinomas and allows carcinoma cells to elude the immune system. PD-L1 expression is associated with the response to anti-programmed death 1 (PD-1)/PD-L1 drugs. This study aimed to clarify the relationship between PD-L1 expression and clinicopathological factors of salivary gland carcinomas (SGCs) and identify its clinical significance. METHODS PD-L1 expression was examined by immunohistochemical analysis using a tissue microarray comprised of 219 surgically resected SGC specimens. Detailed clinicopathological factors, including patient outcome, were available for all cases. RESULTS A case showing complete membranous expression of PD-L1 in more than 1% of whole carcinoma cells was considered positive by ROC analysis. A total of 50 (22.8%) patients showed PD-L1 expression in SGC cells. Positive PD-L1 expression was significantly associated with poor disease free survival (P < 0.001) and overall survival (P < 0.001). Multivariate analysis revealed that positive PD-L1 expression was one of the independent predictors for poor disease free survival (hazard ratio = 2.287, 95% confidence interval = 1.24-4.15; P = 0.008). CONCLUSIONS Positive PD-L1 expression was significantly associated with poor disease free survival of SGCs, suggesting that antibody therapies targeting PD-1/PD-L1 may have potential application in SGCs. J. Surg. Oncol. 2016;114:36-43. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Takashi Mukaigawa
- Department of Head and Neck Surgery, National Cancer Center Hospital East, Kashiwa, Chiba, Japan.,Department of Otolaryngology, Head and Neck Surgery, Ehime University School of Medicine, Toon, Ehime, Japan
| | - Ryuichi Hayashi
- Department of Head and Neck Surgery, National Cancer Center Hospital East, Kashiwa, Chiba, Japan
| | - Kazuki Hashimoto
- Department of Head and Neck Surgery, National Cancer Center Hospital East, Kashiwa, Chiba, Japan
| | - Toru Ugumori
- Department of Otolaryngology, Head and Neck Surgery, Ehime University School of Medicine, Toon, Ehime, Japan
| | - Naohito Hato
- Department of Otolaryngology, Head and Neck Surgery, Ehime University School of Medicine, Toon, Ehime, Japan
| | - Satoshi Fujii
- Division of Pathology, Exploratory Oncology Research and Clinical Trial Center, National Cancer Center, Kashiwa, Chiba, Japan
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36
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Mifsud M, Sharma S, Leon M, Padhya T, Otto K, Caudell J. Salivary Duct Carcinoma of the Parotid: Outcomes with a Contemporary Multidisciplinary Treatment Approach. Otolaryngol Head Neck Surg 2016; 154:1041-6. [PMID: 26980918 DOI: 10.1177/0194599816636812] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2015] [Accepted: 02/11/2016] [Indexed: 12/21/2022]
Abstract
OBJECTIVE Salivary duct carcinoma (SDC) is a rare and aggressive malignancy for which an optimal treatment algorithm is lacking. We endeavored to assess the current treatment outcomes for SDC with a multimodality treatment approach combining surgery with adjuvant radiotherapy ± concurrent chemotherapy. STUDY DESIGN Case series with chart review. SETTING A National Cancer Institute-designated comprehensive cancer center. SUBJECTS AND METHODS The clinical record of 17 patients with salivary duct carcinoma were analyzed to assess locoregional control, recurrence-free survival, and overall survival. RESULTS All SDC cases (n = 17) were managed with surgical resection, followed by adjuvant radiotherapy (47.1%) or concurrent chemotherapy and radiotherapy (52.9%). Median patient follow up was 37 months. An aggressive disease course was generally observed, with 3-year recurrence-free survival and overall survival of 34.4% and 35.5%, respectively. The majority of recurrences were distant. Intensification with adjuvant concurrent chemotherapy was not associated with improved outcomes on univariate survival analysis. CONCLUSION For salivary duct carcinoma, a multimodality treatment approach is associated with acceptable locoregional control rates but poor distant control and overall survival. Novel systemic therapies may be needed to optimize clinical outcomes.
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Affiliation(s)
- Matthew Mifsud
- Department of Otolaryngology-Head and Neck Surgery, University of Toronto, Toronto, Canada Department of Otolaryngology-Head and Neck Surgery, University of South Florida Morsani College of Medicine, Tampa, Florida, USA
| | - Saurabh Sharma
- Department of Otolaryngology-Head and Neck Surgery, University of South Florida Morsani College of Medicine, Tampa, Florida, USA
| | - Marino Leon
- Department of Pathology, H. Lee Moffitt Comprehensive Cancer Center and Research Institute, Tampa, Florida, USA
| | - Tapan Padhya
- Department of Otolaryngology-Head and Neck Surgery, University of South Florida Morsani College of Medicine, Tampa, Florida, USA Department of Head and Neck and Endocrine Oncology, H. Lee Moffitt Comprehensive Cancer Center and Research Institute, Tampa, Florida, USA
| | - Kristen Otto
- Department of Head and Neck and Endocrine Oncology, H. Lee Moffitt Comprehensive Cancer Center and Research Institute, Tampa, Florida, USA
| | - Jimmy Caudell
- Department of Radiation Oncology, H. Lee Moffitt Comprehensive Cancer Center and Research Institute, Tampa, Florida, USA
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Breinholt H, Elhakim MT, Godballe C, Andersen LJ, Primdahl H, Kristensen CA, Bjørndal K. Salivary duct carcinoma: a Danish national study. J Oral Pathol Med 2016; 45:664-671. [PMID: 26822194 DOI: 10.1111/jop.12426] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/28/2015] [Indexed: 01/06/2023]
Abstract
BACKGROUND To present the first national series of salivary duct carcinoma patients, including survival rates and an analysis of prognostic factors. METHODS By merging three Danish nationwide registries that encompass an entire population, 34 patients diagnosed with salivary duct carcinoma from 1990 to 2005 were identified. Histological slides were reviewed, and data concerning demographics, tumour site, clinical stage, treatment profiles and follow-up were retrieved. Survival estimates and prognostic factors were evaluated by comparing Kaplan-Meier plots using the Mantel-Haenszel log-rank test. RESULTS Salivary duct carcinoma showed an incidence of 0.04/100.000 inhabitants/year. Distant recurrence was seen in 52% of patients. Five-year overall survival, disease-specific survival and recurrence-free survival were 32%, 42% and 35%, respectively. Univariate analyses suggested that overall stage (III/IV) and vascular invasion have a negative impact on all survival measures. Involved resection margins correlated with a poorer overall survival and disease-specific survival, whereas adjuvant radiotherapy improved overall survival and recurrence-free survival. CONCLUSIONS Salivary duct carcinoma incidence averages to two episodes per year in the entire Kingdom of Denmark. With half of patients in this study experiencing distant recurrences and only a third surviving at 5 years, prognosis is dismal. Advanced overall stage, vascular invasion and involved resection margins all seem to correlate with a poorer survival, while adjuvant radiotherapy significantly improved outcome. Extensive T-site surgery, neck dissection and adjuvant radiotherapy are therefore recommended.
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Affiliation(s)
- Helle Breinholt
- Department of ORL - Head and Neck Surgery, Odense University Hospital, Odense, Denmark
| | | | - Christian Godballe
- Department of ORL - Head and Neck Surgery, Odense University Hospital, Odense, Denmark
| | | | - Hanne Primdahl
- Department of Oncology, Aarhus University Hospital, Aarhus, Denmark
| | - Claus A Kristensen
- Department of Oncology, Copenhagen University Hospital/Rigshospitalet, Copenhagen, Denmark
| | - Kristine Bjørndal
- Department of ORL - Head and Neck Surgery, Odense University Hospital, Odense, Denmark.
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38
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Otsuka K, Imanishi Y, Tada Y, Kawakita D, Kano S, Tsukahara K, Shimizu A, Ozawa H, Okami K, Sakai A, Sato Y, Ueki Y, Sato Y, Hanazawa T, Chazono H, Ogawa K, Nagao T. Clinical Outcomes and Prognostic Factors for Salivary Duct Carcinoma: A Multi-Institutional Analysis of 141 Patients. Ann Surg Oncol 2016; 23:2038-45. [PMID: 26790669 PMCID: PMC4858547 DOI: 10.1245/s10434-015-5082-2] [Citation(s) in RCA: 68] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2015] [Indexed: 12/15/2022]
Abstract
BACKGROUND Among salivary gland malignancies, the prognosis of salivary duct carcinoma (SDC) is assumed to be the poorest. However, because of its low incidence, reliable survival estimates and prognostic factors based on a large number of patients remain to be elucidated, thereby making it impossible to standardize the optimal treatment for SDC. METHODS We performed this multi-institutional, retrospective analysis by collecting the clinical information of 141 patients with SDC without distant metastasis who underwent curative surgery as the initial treatment to elucidate overall survival (OS) and disease-free survival (DFS) along with their prognostic factors. RESULTS The 3-year OS and DFS rates were 70.5 and 38.2 %, respectively. Multivariate analysis revealed that age ≥65 years (p < 0.001) and N1 and N2 (p = 0.047 and <0.001, respectively) were independent prognostic factors for OS, whereas the primary site of the minor salivary and sublingual gland (p < 0.001) and N2 (p < 0.001) were those for DFS. The most common treatment failure was distant metastasis (55 patients, 39.0 %). For early parotid SDC, neither total parotidectomy in the patients with early T stage nor nerve resection in the patients without facial nerve palsy showed survival benefits. CONCLUSIONS Advanced N stage independently affects both OS and DFS. Partial parotidectomy with facial nerve preservation could be a less invasive standard surgical procedure for parotid gland SDC in the early T stage without facial nerve palsy. Effective systemic therapy is imperative to improve DFS of SDC.
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Affiliation(s)
- Kuninori Otsuka
- Department of Otorhinolaryngology-Head and Neck Surgery, Keio University School of Medicine, Tokyo, Japan.,Department of Otorhinolaryngology, Saiseikai Yokohama Tobu Hospital, Yokohama, Japan
| | - Yorihisa Imanishi
- Department of Otorhinolaryngology-Head and Neck Surgery, Keio University School of Medicine, Tokyo, Japan.
| | - Yuichiro Tada
- Department of Head and Neck Oncology and Surgery, International University of Health and Welfare Mita Hospital, Tokyo, Japan
| | - Daisuke Kawakita
- Department of Otolaryngology-Head and Neck Surgery, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Satoshi Kano
- Department of Otolaryngology-Head and Neck Surgery, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Kiyoaki Tsukahara
- Department of Otolaryngology, Tokyo Medical University School of Medicine, Tokyo, Japan
| | - Akira Shimizu
- Department of Otolaryngology, Tokyo Medical University School of Medicine, Tokyo, Japan
| | - Hiroyuki Ozawa
- Department of Otorhinolaryngology-Head and Neck Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Kenji Okami
- Department of Otolaryngology-Head and Neck Surgery, Tokai University School of Medicine, Isehara, Japan
| | - Akihiro Sakai
- Department of Otolaryngology-Head and Neck Surgery, Tokai University School of Medicine, Isehara, Japan
| | - Yuichiro Sato
- Department of Head and Neck Surgery, Niigata Cancer Center Hospital, Niigata, Japan
| | - Yushi Ueki
- Department of Head and Neck Surgery, Niigata Cancer Center Hospital, Niigata, Japan
| | - Yukiko Sato
- Department of Pathology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Toyoyuki Hanazawa
- Department of Otolaryngology, Head and Neck Surgery, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Hideaki Chazono
- Department of Otolaryngology, Head and Neck Surgery, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Kaoru Ogawa
- Department of Otorhinolaryngology-Head and Neck Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Toshitaka Nagao
- Department of Anatomic Pathology, Tokyo Medical University School of Medicine, Tokyo, Japan
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39
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Carcinoma ex-pleomorphic adenoma of the salivary glands has a high risk of progression when the tumor invades more than 2.5 mm beyond the capsule of the residual pleomorphic adenoma. Virchows Arch 2015; 468:297-303. [DOI: 10.1007/s00428-015-1887-4] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2015] [Revised: 09/23/2015] [Accepted: 11/22/2015] [Indexed: 11/26/2022]
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40
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Ductal activation of oncogenic KRAS alone induces sarcomatoid phenotype. Sci Rep 2015; 5:13347. [PMID: 26289340 PMCID: PMC4642517 DOI: 10.1038/srep13347] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2015] [Accepted: 07/22/2015] [Indexed: 01/01/2023] Open
Abstract
Salivary duct carcinoma (SDC) is an uncommon, but aggressive malignant tumor with a high mortality rate. Herein, we reported the detection of somatic KRAS A146T and Q61H mutations in 2 out of 4 (50%) sarcomatoid SDC variants. Transgenic mice carrying the human oncogenic KRASG12V, which spatiotemporal activation by tamoxifen (TAM)-inducible Cre recombinase Ela-CreERT in the submandibular gland (SMG) ductal cells, was established and characterized. Visible carcinoma was detected as early as day-15 following oncogenic KRASG12V induction alone, and these tumors proliferate rapidly with a median survival of 28-days accompanied with histological reminiscences to human sarcomatoid SDC variants. Moreover, these tumors were resistant to cetuximab treatment despite augmented EGFR signaling, attesting its malignancy. Our findings suggest that LGL-KRasG12V;Ela-CreERT transgenic mice could serve as a useful preclinical model for investigating underlying mechanisms and developing potential therapies.
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41
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Johnston ML, Huang SH, Waldron JN, Atenafu EG, Chan K, Cummings BJ, Gilbert RW, Goldstein D, Gullane PJ, Irish JC, Perez-Ordonez B, Weinreb I, Bayley A, Cho J, Dawson LA, Hope A, Ringash J, Witterick IJ, O'Sullivan B, Kim J. Salivary duct carcinoma: Treatment, outcomes, and patterns of failure. Head Neck 2015; 38 Suppl 1:E820-6. [PMID: 25916947 DOI: 10.1002/hed.24107] [Citation(s) in RCA: 70] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/16/2015] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Salivary duct carcinoma is rare, with distinct morphology and behavior. We reviewed our institutional experience with salivary duct carcinoma, aiming to characterize clinical behavior and treatment outcomes. METHODS All salivary duct carcinomas treated curatively between 1999 and 2010 were reviewed. Overall survival (OS), locoregional control, distant control, and patterns of failure were analyzed. Multivariate analysis identified predictors of OS. RESULTS Fifty-four patients with salivary duct carcinoma (parotid gland = 49; submandibular gland = 5) were included in the analysis. Fifty-three patients underwent primary surgery, and 48 (89%) received postoperative radiotherapy (RT; median dose = 60 Gy). Median follow-up was 5.7 years. The 5-year OS, locoregional control, and distant control were 43%, 70%, and 48%, respectively. Nine local (6 involving facial nerve), 10 regional, and 28 distant failures were identified. Multiple pathologic involved lymph nodes (pN2b/N2c) predicted reduced OS (hazard ratio [HR] = 3.6; p = .02). CONCLUSION Distant recurrence is common. Presence of pN2b/N2c disease is associated with reduced OS. Local recurrence frequently involves the facial nerves. © 2015 Wiley Periodicals, Inc. Head Neck 38: E820-E826, 2016.
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Affiliation(s)
- Meredith L Johnston
- Radiation Medicine Program, Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario, Canada
| | - Shao Hui Huang
- Radiation Medicine Program, Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario, Canada
| | - John N Waldron
- Radiation Medicine Program, Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario, Canada
| | - Eshetu G Atenafu
- Department of Biostatistics, University Health Network, Princess Margaret Cancer Centre, Toronto, Ontario, Canada
| | - Kelvin Chan
- Department of Medical Oncology Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario, Canada
| | - Bernard J Cummings
- Radiation Medicine Program, Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario, Canada
| | - Ralph W Gilbert
- Department of Otolaryngology - Head and Neck Surgery/Surgical Oncology, Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario, Canada
| | - David Goldstein
- Department of Otolaryngology - Head and Neck Surgery/Surgical Oncology, Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario, Canada
| | - Patrick J Gullane
- Department of Otolaryngology - Head and Neck Surgery/Surgical Oncology, Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario, Canada
| | - Jonathan C Irish
- Department of Otolaryngology - Head and Neck Surgery/Surgical Oncology, Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario, Canada
| | | | - Ilan Weinreb
- Department of Pathology, University Health Network, Toronto, Ontario, Canada
| | - Andrew Bayley
- Radiation Medicine Program, Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario, Canada
| | - John Cho
- Radiation Medicine Program, Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario, Canada
| | - Laura A Dawson
- Radiation Medicine Program, Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario, Canada
| | - Andrew Hope
- Radiation Medicine Program, Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario, Canada
| | - Jolie Ringash
- Radiation Medicine Program, Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario, Canada
| | - Ian J Witterick
- Department of Otolaryngology - Head and Neck Surgery/Surgical Oncology, Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario, Canada
| | - Brian O'Sullivan
- Radiation Medicine Program, Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario, Canada
| | - John Kim
- Radiation Medicine Program, Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario, Canada
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42
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Salivary duct carcinoma: the predominance of apocrine morphology, prevalence of histologic variants, and androgen receptor expression. Am J Surg Pathol 2015; 39:705-13. [PMID: 25871467 DOI: 10.1097/pas.0000000000000413] [Citation(s) in RCA: 86] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Salivary duct carcinoma (SDC) is a prototypic aggressive salivary gland carcinoma. Our aim is to determine the prevalence of histologic variants (micropapillary, basal-like) and androgen receptor (AR) expression in a large multi-institutional series of SDC. AR status was determined by immunohistochemistry (IHC). Most SDCs were characterized by an apocrine phenotype and AR expression. Cases with a nonapocrine phenotype and AR-negative status were studied by additional IHC and fluorescence in situ hybridization for ETV6 or MYB/NFIB. The diagnosis of SDC was confirmed in 187 of 199 (94%) cases. Variant morphologies were identified in 12 cases: micropapillary (n=6), sarcomatoid (n=3), mucinous (n=2), and basal-like (n=1). AR IHC was performed in 183 cases, of which 179 (97.8%) showed AR expression. On the basis of morphologic appearance and results of additional studies, 12 cases were reclassified as squamous cell carcinoma (SCC) (n=4), epithelial-myoepithelial carcinoma with high-grade transformation (HGT) (n=2), myoepithelial carcinoma (n=2), mammary analogue secretory carcinoma, high grade (ETV6 translocated; n=1), adenoid cystic carcinoma with HGT (n=1), acinic cell carcinoma with HGT (n=1), and adenosquamous carcinoma (n=1). AR-negative SDC is extremely rare, and the majority of such cases are more accurately classified as other entities. HGTs of other salivary carcinomas and squamous cell carcinoma are the most common mimics of SDC. SDCs with variant morphologies still show at least a minor component of conventional apocrine appearance. Thus, apocrine morphology defines SDC.
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43
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Nickelsen MN, VON Holstein S, Hansen AB, Prause JU, Heegaard S. Breast carcinoma metastasis to the lacrimal gland: Two case reports. Oncol Lett 2015; 10:1031-1035. [PMID: 26622620 DOI: 10.3892/ol.2015.3282] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2014] [Accepted: 05/12/2015] [Indexed: 01/06/2023] Open
Abstract
A 77-year-old female, with proptosis, reduced eye motility and diplopia which had developed over two to three months and a 69-year-old female with proptosis, oedema of the eyelid, reduced motility and ptosis, which had developed over three weeks, are presented in the present study. Computed tomography scans revealed irregular lacrimal gland tumours in the two patients. The two patients had history of breast cancer. The first breast cancer metastasis in the lacrimal gland demonstrated a cribriform growth pattern containing ductal elements. The epithelial tumour cells stained positive for cytokeratin (1-8, 10, 14-16, 18 and 19), oestrogen receptor, epithelial membrane antigen (EMA), carcinoembryonic antigen (CEA) and gross cystic disease fluid protein 15 (GCDFP-15). The second metastatic tumour was positive for EMA and estrogen receptor, but variably positive for CEA and GCDFP-15. The metastasis in the lacrimal gland was a pleomorphic tumour. The tumour cells were positive for EMA and variably positive for oestrogen and CEA. Metastases to the lacrimal gland are extremely rare, and metastases to the lacrimal gland should be considered in the diagnoses of lacrimal gland tumours. The present study aimed to describe two such cases and draw attention to breast carcinomas as a differential diagnosis and the most frequent cause of lacrimal gland metastasis.
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Affiliation(s)
- Marie N Nickelsen
- Eye Pathology Section, University of Copenhagen, Copenhagen 2100, Denmark
| | - Sarah VON Holstein
- Eye Pathology Section, University of Copenhagen, Copenhagen 2100, Denmark ; Department of Ophthalmology, University Hospital Glostrup, Glostrup, Greater Copenhagen 2600, Denmark
| | - Alastair B Hansen
- Department of Pathology, Copenhagen University Hospital at Herlev, Copenhagen 2730, Denmark
| | - Jan U Prause
- Eye Pathology Section, University of Copenhagen, Copenhagen 2100, Denmark
| | - Steffen Heegaard
- Eye Pathology Section, University of Copenhagen, Copenhagen 2100, Denmark ; Department of Ophthalmology, University Hospital Glostrup, Glostrup, Greater Copenhagen 2600, Denmark
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44
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Huang X, Hao J, Chen S, Deng R. Salivary duct carcinoma: A clinopathological report of 11 cases. Oncol Lett 2015; 10:337-341. [PMID: 26171026 DOI: 10.3892/ol.2015.3176] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2014] [Accepted: 01/13/2015] [Indexed: 12/18/2022] Open
Abstract
The aim of the present study was to summarize the clinicopathological and immunohistochemical characteristics of salivary duct carcinoma (SDC) and to evaluate the currently available treatment modalities. Between 2001 and 2011, 11 patients with SDC were diagnosed and treated at the Affiliated Hospital of Stomatology of Nanjing University (Nanjing, Jiangsu, China). The present study retrospectively reviewed the clinicopathological and immunohistochemical data of these 11 patients and the results indicated that the parotid gland was the most commonly affected site, followed by the submandibular gland and the palate. Furthermore, the mean age of onset was 58.8 years and all cases were treated with surgery, with 72.7% receiving post-operative radiation therapy. The range for the follow-up period was 10-89 months and of the 11 patients investigated, only two succumbed to the disease. In addition, the two-year overall survival rate was 75% according to Kaplan-Meier analysis and the mean overall survival time was 72.8 months. In conclusion, the present study determined that the site of the malignancy is the best predictor of survival in patients with the rare salivary malignancy SDC, while age, gender, T stage, N stage, American Joint Committee on Cancer stage, nerve paralysis, post-operative radiation, neck dissection, and protein expression levels of Ki-67, androgen receptor and human epidermal growth factor-2/neu are less influential factors.
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Affiliation(s)
- Xiaofeng Huang
- Department of Pathology, Affiliated Hospital of Stomatology, Medical School, Nanjing University, Nanjing, Jiangsu 210000, P.R. China
| | - Jing Hao
- Central Laboratory, Affiliated Hospital of Stomatology, Medical School, Nanjing University, Nanjing, Jiangsu 210000, P.R. China
| | - Sheng Chen
- Department of Pathology, Affiliated Hospital of Stomatology, Medical School, Nanjing University, Nanjing, Jiangsu 210000, P.R. China
| | - Runzhi Deng
- Department of Oral and Maxillofacial Surgery, Affiliated Hospital of Stomatology, Medical School, Nanjing University, Nanjing, Jiangsu 210000, P.R. China
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45
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Is there a role of adjuvant treatment for salivary duct carcinoma? The Journal of Laryngology & Otology 2015; 129 Suppl 2:S98-101. [DOI: 10.1017/s0022215114002965] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
AbstractObjective:To determine the clinical effect of post-operative radiotheraphy and systemic chemotherapy for the treatment of salivary duct carcinoma.Study design:Retrospective review.Design:The medical records of 26 patients treated by surgery with or without radiotheraphy and/or systemic chemotherapy for salivary duct carcinoma were retrospectively reviewed to investigate the role of post-operative adjuvant treatment for the patients' prognosis.Results:The overall three-year and five-year survival rates were 54 and 48.1 per cent, respectively. There was no correlation with the clinical stage and the patients' prognosis. The overall three-year survival of the patients with or without post-operative radiotheraphy was 64 and 33 per cent, respectively (p = 0.29). The overall three-year survival of the patients with or without post-operative chemotherapy was 53 and 56 per cent, respectively (p = 0.78).Conclusion:Post-operative adjuvant therapy did not improve the patients' overall prognosis with salivary duct carcinoma. Developing novel treatment modalities may be necessary to improve the prognosis of this aggressive disease.
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46
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Bourell LG, Chan KC, Hirsch DL. Salivary Duct Carcinoma Ex Pleomorphic Adenoma of the Palate: A Case Report. J Oral Maxillofac Surg 2015; 73:370.e1-7. [DOI: 10.1016/j.joms.2014.08.040] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2014] [Revised: 08/15/2014] [Accepted: 08/19/2014] [Indexed: 12/26/2022]
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47
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Gokavarapu S, Fonseca D, Puthamakula S, Reddy BP, Reddy BS, Murthy S. HER2/neu negative salivary duct carcinoma of parotid: A case with forty months recurrence free follow up. Int J Surg Case Rep 2015; 8C:22-4. [PMID: 25603487 PMCID: PMC4353959 DOI: 10.1016/j.ijscr.2015.01.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2014] [Revised: 12/08/2014] [Accepted: 01/03/2015] [Indexed: 11/23/2022] Open
Abstract
Salivary duct carcinoma is a rare aggressive tumor. Current case showed recurrence free 40 months follow up. HER2/neu negativity in this case might have significance regarding recurrence free survival.
Introduction Salivary duct carcinoma (SDC) is very rare, only 1–3% of all salivary gland tumors are reported as SDC. SDC predominantly occurs in elderly males, SCD is characterized by an aggressive clinical course of the disease with less than 60% five years survival from the day of initial diagnosis, lymph node metastasis and facial nerve involvement is common, the current literature lacks protocol regarding management of this entity and the advantage of adjuvant therapy has not been evaluated due to its rare occurrence. Presentation of case We report patient with stage IV HER2/neu negative SDC successfully treated with surgery followed by adjuvant radiotherapy, patient is followed up for 40 months without evidence of recurrence or metastasis. Discussion SDC is reported to be similar to mammary duct carcinoma in clinical and immunohistologic typing, further it shows an association of expression of HER-2/neu and p53, with early local disease recurrence, distant metastasis and survival, however; current case was adequately followed up and reevaluated after 26 months, MRI did not show evidence of recurrence. Conclusion SDC is a rare tumor and information on association of HER2/neu with survival is useful in further research on this tumor.
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Affiliation(s)
- Sandhya Gokavarapu
- Basavatarakam Indo American Cancer Hospital and Research Centre, Hyderabad, Andhra Pradesh 500034, India.
| | - Daphne Fonseca
- Basavatarakam Indo American Cancer Hospital and Research Centre, Hyderabad, Andhra Pradesh 500034, India.
| | - Sreenivasa Puthamakula
- Basavatarakam Indo American Cancer Hospital and Research Centre, Hyderabad, Andhra Pradesh 500034, India.
| | - Bal P Reddy
- Government Dental College and Hospital, Hyderabad, Andhra Pradesh 500034, India.
| | - B Sridhar Reddy
- Government Dental College and Hospital, Hyderabad, Andhra Pradesh 500034, India.
| | - Sudha Murthy
- Basavatarakam Indo American Cancer Hospital and Research Centre, Hyderabad, Andhra Pradesh 500034, India.
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48
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Zhu S, Schuerch C, Hunt J. Review and Updates of Immunohistochemistry in Selected Salivary Gland and Head and Neck Tumors. Arch Pathol Lab Med 2015; 139:55-66. [DOI: 10.5858/arpa.2014-0167-ra] [Citation(s) in RCA: 90] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Context
Immunohistochemistry is a useful tool for diagnosing salivary gland and head and neck tumors.
Objective
To review immunohistochemical markers, which can aid in the diagnosis of selected salivary gland and head and neck tumors.
Data Sources
Literature review and authors' personal practice experience.
Conclusions
Salivary gland and head and neck tumors include a large diverse group of tumors with complex and overlapping histologic features. Immunohistochemistry plays an important role in resolving the differential diagnosis of some salivary gland and head and neck tumors and can provide information for the prognosis of certain tumors.
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Affiliation(s)
- Shaobo Zhu
- From the Department of Laboratory Medicine, Geisinger Medical Center, Danville, Pennsylvania (Drs Zhu and Schuerch)
| | - Conrad Schuerch
- From the Department of Laboratory Medicine, Geisinger Medical Center, Danville, Pennsylvania (Drs Zhu and Schuerch)
| | - Jennifer Hunt
- and the Department of Pathology, University of Arkansas for Medical Sciences, Little Rock (Dr Hunt)
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49
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Tomihara K, Hamashima T, Nagao T, Nakamori K, Sasahara M, Noguchi M. Sarcomatoid salivary duct carcinoma of the palate: a rare case report. Oral Surg Oral Med Oral Pathol Oral Radiol 2014; 119:e27-32. [PMID: 25443810 DOI: 10.1016/j.oooo.2014.08.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2013] [Revised: 08/02/2014] [Accepted: 08/10/2014] [Indexed: 10/24/2022]
Abstract
Salivary duct carcinoma (SDC) is an uncommon neoplasm that most commonly occurs in major salivary glands, mainly the parotid gland. SDC is rarely found in the minor salivary glands of the oral cavity. This report presents an extremely rare case of sarcomatoid SDC originating in a minor salivary gland of the palate. The tumor was histologically characterized by the presence of both carcinomatous and sarcomatoid components. The patient presented with a painless mass in the right palate, which slowly increased in size over 20 years. The clinical course of the present case suggests that the tumor most probably developed as a result of malignant transformation of a preexisting benign tumor of the palatal salivary gland. This report describes the clinical and histologic features of this extremely rare case of sarcomatoid SDC with reference to the relevant literature.
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Affiliation(s)
- Kei Tomihara
- Department of Oral and Maxillofacial Surgery, Graduate School of Medicine and Pharmaceutical Sciences for Research, University of Toyama, Toyama, Japan.
| | - Takeru Hamashima
- Department of Pathology, Graduate School of Medicine and Pharmaceutical Sciences for Research, University of Toyama, Toyama, Japan
| | - Toshitaka Nagao
- Department of Anatomic Pathology, Tokyo Medical University, Tokyo, Japan
| | - Kenji Nakamori
- Department of Oral and Maxillofacial Surgery, Graduate School of Medicine and Pharmaceutical Sciences for Research, University of Toyama, Toyama, Japan
| | - Masakiyo Sasahara
- Department of Pathology, Graduate School of Medicine and Pharmaceutical Sciences for Research, University of Toyama, Toyama, Japan
| | - Makoto Noguchi
- Department of Oral and Maxillofacial Surgery, Graduate School of Medicine and Pharmaceutical Sciences for Research, University of Toyama, Toyama, Japan
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50
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Shi S, Fang Q, Liu F, Zhong M, Sun C. Prognostic factors and survival rates for parotid duct carcinoma patients. J Craniomaxillofac Surg 2014; 42:1929-31. [DOI: 10.1016/j.jcms.2014.08.001] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2014] [Revised: 05/21/2014] [Accepted: 08/05/2014] [Indexed: 10/24/2022] Open
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