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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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Campos-Gómez S, Flores-Arredondo JH, Dorantes-Heredia R, Chapa-Ibargüengoitia M, de la Peña-Lopez R. Case report: anti-hormonal therapy in the treatment of ductal carcinoma of the parotid gland. BMC Cancer 2014; 14:701. [PMID: 25249211 PMCID: PMC4190344 DOI: 10.1186/1471-2407-14-701] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2014] [Accepted: 08/26/2014] [Indexed: 11/18/2022] Open
Abstract
Background Ductal carcinomas of the parotid gland are rare, highly aggressive, have a poor prognosis and are histologically similar to Ductal Breast Cancer. We report what we believe to be the first case in literature of metastatic salivary duct carcinoma (SDC) of the parotid gland with objective response to tamoxifen and aromatase inhibitors, achieving a long-term stability of disease with no associated toxicity. Case presentation A 70-year-old female was referred to our institution for treatment of a painless nodular lesion in the scalp, localized in the frontal region of the cranium. A biopsy was taken and tested positive for metastatic ductal carcinoma. On PET CT hypermetabolic nodules were localized in the left parotid gland (11 mm), right parotid gland (10 and 12 mm), submandibular node (11 mm) and left cervical node (10 mm). A salivary ductal carcinoma was considered to be the primary tumor. The patient was subsequently started on tamoxifen, with a complete response from the scalp nodule and left parotid nodule, while the right parotid nodule demonstrated a partial response that maintained stable for 2 years until progression. Anastrazol was chosen as the next line of treatment, achieving 6 more months of stable disease. As a pseudo-adjuvant treatment, surgical resection of the right parotid lesion was performed and helped achieve two years of disease stability. Conclusions Estrogen receptor antagonists such as tamoxifen or aromatase inhibitors may represent a target for the establishment of a safe alternative and novel therapy for SDC, however more accurate data obtained from larger studies are required.
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Affiliation(s)
- Saúl Campos-Gómez
- Departamento de Oncología Médica, Centro Oncológico Estatal, ISSEMYM, Toluca, México.
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Kallianpur A, Yadav R, Shukla NK, Deo SVS, Muduly DK. Locally advanced salivary duct carcinoma of the parotid gland. Ann Maxillofac Surg 2013; 2:178-81. [PMID: 23482905 PMCID: PMC3591061 DOI: 10.4103/2231-0746.101354] [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] [Indexed: 11/15/2022] Open
Abstract
Due to the low incidence of salivary duct carcinoma (SDC), there is limited data in regard to the biologic behavior of this tumor, histopathological characteristics and its management. There is diversity in the management of parotid SDC. Various authors manage it with radical parotidectomy with or without neck dissection; others add adjuvant radiotherapy with radical surgery. The objective of the study is to see the biological behavior and management of the three patients with locally advanced SDC and review with the literature.
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Affiliation(s)
- Ashwin Kallianpur
- Dr. BRA-IRCH, Department of Surgical Oncology, All India Institute of Medical Sciences, New Delhi, India
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4
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Pont E, Plá Á, Cruz Mojarrieta J, Ferrandis E, Brotons S, Vendrell JB. Carcinoma ductal salival: claves diagnósticas, histología y tratamiento. ACTA OTORRINOLARINGOLOGICA ESPANOLA 2013; 64:150-3. [DOI: 10.1016/j.otorri.2011.10.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2011] [Revised: 10/10/2011] [Accepted: 10/20/2011] [Indexed: 11/27/2022]
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5
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Pont E, Plá Á, Cruz Mojarrieta J, Ferrandis E, Brotons S, Vendrell JB. Salivary Duct Carcinoma: Diagnostic Clues, Histology and Treatment. ACTA OTORRINOLARINGOLOGICA ESPANOLA 2013. [DOI: 10.1016/j.otoeng.2013.04.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Vander Poorten V, Bradley PJ, Takes RP, Rinaldo A, Woolgar JA, Ferlito A. Diagnosis and management of parotid carcinoma with a special focus on recent advances in molecular biology. Head Neck 2011; 34:429-40. [DOI: 10.1002/hed.21706] [Citation(s) in RCA: 61] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2010] [Revised: 10/19/2010] [Accepted: 10/26/2010] [Indexed: 11/05/2022] Open
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Vander Poorten VLM, Marchal F, Nuyts S, Clement PMJ. Parotid carcinoma: Current diagnostic workup and treatment. Indian J Surg Oncol 2010; 1:96-111. [PMID: 22930624 PMCID: PMC3421013 DOI: 10.1007/s13193-010-0022-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2009] [Accepted: 04/30/2010] [Indexed: 01/04/2023] Open
Abstract
In this review we present recent progress in diagnostic workup, prognostic evaluation, treatment options and resulting outcomes. Whenever possible, complete resection remains the mainstay of treatment. Sacrifice of facial nerve branches is reserved for the clinically or electromyographically dysfunctioning facial nerve. Clinical or radiological neck disease demands combined surgery and radiotherapy. Treatment of the N0 neck is indicated for advanced stage-high grade tumors but the question remains unanswered whether this should be surgical or radiotherapeutic elective treatment. Surgery alone will cure low stage, low grade tumors, that show no additional negative prognostic factors following adequate resection. In all other tumors postoperative radiotherapy will improve locoregional control. This approach results in good locoregional control, in a way that distant metastasis remains the typical presentation of treatment failure. In this setting, the results of systemic treatment today remain limited, but a huge effort in the molecular biology field has been done to introduce targeted therapy into this domain of head and neck cancer. Disease control remains variable within the patient population. This variation can increasingly be predicted by systems that incorporate the combined information of multivariately identified and quantified prognostic factors into an individualized prognosis for the parotid carcinoma patient.
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Affiliation(s)
- Vincent L. M. Vander Poorten
- Department of Otorhinolaryngology, Head and Neck Surgery and Leuven Cancer Institute, University Hospitals Leuven, KULeuven, Leuven, Belgium
- European Salivary Gland Society, Geneva, Switzerland
| | - Francis Marchal
- Department of Otorhinolaryngology, Head and Neck Surgery, CHU Geneve and Hôpital Général Beaulieu, European Salivary Gland Society, Geneva, Switzerland
| | - Sandra Nuyts
- Department of Radiotherapy-Oncology and Leuven Cancer Institute, University Hospitals Leuven, KULeuven, Leuven, Belgium
| | - Paul M. J. Clement
- Department of Medical Oncology and Leuven Cancer Institute, University Hospitals Leuven, KULeuven, Leuven, Belgium
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Jamal AM, Sun ZJ, Chen XM, Zhao YF. Salivary duct carcinoma of the parotid gland: case report and review of the literature. J Oral Maxillofac Surg 2008; 66:1708-13. [PMID: 18634961 DOI: 10.1016/j.joms.2007.05.024] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2007] [Revised: 03/08/2007] [Accepted: 05/08/2007] [Indexed: 10/21/2022]
Affiliation(s)
- Alsharif Mohd Jamal
- Department of Oral and Maxillofacial Surgery, School and Hospital of Stomatology, Wuhan University, Wuhan, China
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9
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Her-2/neu expression in salivary duct carcinoma: an immunohistochemical and chromogenic in situ hybridization study. Appl Immunohistochem Mol Morphol 2008; 16:54-8. [PMID: 18091319 DOI: 10.1097/pai.0b013e31802e91b2] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Salivary duct carcinoma (SDC) shares significant morphologic and immunophenotypic overlap with ductal carcinoma of the breast, including HER-2/neu expression. Previous studies have detected HER-2/neu at the protein level in SDCs; however, no study, to date, has assayed whether this expression is related to gene amplification detected by chromogenic in situ hybridization (CISH). Formalin-fixed, paraffin-embedded tissue sections from 12 previously diagnosed SDCs were evaluated by immunohistochemistry (IHC) and CISH for HER-2/neu status. Result concordance was seen in all 12 cases. A total of 4 SDCs were positive by IHC; all 4 cases showed amplification with CISH. The remaining 8 cases were negative by IHC and showed no gene amplification with CISH. SDCs in this study show HER-2/neu overexpression on both the protein and gene levels in approximately 30% of cases. These findings suggest a role may exist for Herceptin (trastuzumab) based therapy in some SDC patients.
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Milman T, Shields JA, Husson M, Marr BP, Shields CL, Eagle RC. Primary Ductal Adenocarcinoma of the Lacrimal Gland. Ophthalmology 2005; 112:2048-51. [PMID: 16271319 DOI: 10.1016/j.ophtha.2005.04.029] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2005] [Accepted: 04/04/2005] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE To report the case of a 59-year-old man with a right lacrimal gland mass, subsequently diagnosed as primary ductal adenocarcinoma of the lacrimal gland. DESIGN Interventional case report. METHODS We report the clinical presentation, histopathologic and immunohistochemical features, and treatment of a patient with primary ductal adenocarcinoma of the lacrimal gland. The current literature regarding this uncommon neoplasm also is reviewed. RESULTS Excisional biopsy revealed primary ductal adenocarcinoma of the lacrimal gland. The patient subsequently underwent extensive local resection of the tumor and is awaiting radiotherapy to the orbit and neck. A literature search revealed only 3 prior reports of primary ductal adenocarcinoma of the lacrimal gland. CONCLUSIONS Although uncommon, primary ductal adenocarcinoma of the lacrimal gland displays characteristic histologic and immunohistochemical findings that allow its distinction from the other primary lacrimal gland adenocarcinomas. Awareness and recognition of this rare malignancy may aid in further delineation of its biologic behavior, management, and prognosis.
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Affiliation(s)
- Tatyana Milman
- Department of Pathology, Wills Eye Hospital, Thomas Jefferson University, Philadelphia, Pennsylvania 19107, USA
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Etges A, Pinto DS, Kowalski LP, Soares FA, Araújo VC. Salivary duct carcinoma: immunohistochemical profile of an aggressive salivary gland tumour. J Clin Pathol 2004; 56:914-8. [PMID: 14645349 PMCID: PMC1770135 DOI: 10.1136/jcp.56.12.914] [Citation(s) in RCA: 69] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
BACKGROUND Salivary duct carcinoma (SDC) is considered to be a distinct malignancy of the major salivary glands, because of its highly aggressive behaviour, and the high rate of recurrence, metastasis, and disease related death. AIMS To investigate expression of the proteins involved in the retinoblastoma (pRb) and p53 pathways, which control cell cycle progression at the G1/S checkpoint, and also expression of the c-erbB-2 oncoprotein in SDCs. METHODS Using a streptavidin-biotin method, five cases of SDC were evaluated immunohistochemically for the presence of cyclin D1, CDK4 (cyclin dependent kinase 4), p16 (CDK2A), pRb (retinoblastoma protein), E2F-1, p53, mdm2 (murine double minute 2), bcl-2, and the c-erbB-2 oncoprotein to determine whether there was a correlation between the expression of these proteins and patient outcome. RESULTS All of the cases showed deregulation of the pRb and p53 pathways. Of the five patients analysed, only the patient with longterm survival (10 years) was not positive for c-erbB-2 expression. CONCLUSIONS c-erbB-2 overexpression was associated with a poor prognosis. Aggressive behaviour, recurrence, and metastatic potential do not appear to be related to cell cycle deregulation, but seem to be associated with the c-erbB-2 oncoprotein, which is involved in matrix degradation and proteolitic activity, in addition to increases in vessel permeability, endothelial cell growth, proliferation, migration, and differentiation. There was a correlation between c-erbB-2 oncoprotein expression and aggressive behaviour in SDCs.
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Affiliation(s)
- A Etges
- Oral Pathology, School of Dentistry, Federal University of Pelotas/UFP, Pelotas, Rio Grande do Sol, Brazil, CEP 96015
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Toyoda H, Yamaguchi K, Miura K, Fukuda H, Hashimoto K. Salivary duct carcinoma in the submandibular region. Int J Oral Maxillofac Surg 2003; 32:427-9. [PMID: 14505630 DOI: 10.1054/ijom.2002.0343] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
A case of salivary duct carcinoma arising in the submandibular region of an 83-year-old man is presented. Histologically, the tumour consisted of solid cell nests with ductal structures. Tumour cell nests showed central comedonecrosis. Immunohistochemically, the tumour cells were positive for keratin and epithelial membrane antigen but negative for S-100 protein and calponin. Clinical features as well as pathological examinations based on haematoxylin-eosin and immunohistochemical stainings were important in the diagnosis of this case.
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Affiliation(s)
- H Toyoda
- Department of Oral and Maxillofacial Surgery, Hamamatsu University School of Medicine, Hamamatsu, Shizuoka 431-3192, Japan.
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Simpson RHW, Prasad AR, Lewis JE, Skálová A, David L. Mucin-rich variant of salivary duct carcinoma: a clinicopathologic and immunohistochemical study of four cases. Am J Surg Pathol 2003; 27:1070-9. [PMID: 12883239 DOI: 10.1097/00000478-200308000-00004] [Citation(s) in RCA: 87] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Salivary duct carcinoma is a relatively uncommon aggressive neoplasm, typically found in the parotid glands of older men. The histologic appearance is that of an in situ and invasive high-grade adenocarcinoma, and it closely resembles ductal carcinoma of the breast. Several variants of the latter are very well known, but only papillary, sarcomatoid, and low-grade subtypes have so far been reported in salivary duct carcinoma. This study describes the clinicopathologic and immunohistochemical findings in four examples of an additional previously undescribed variant, rich in mucin. Each tumor showed areas of typical salivary duct carcinoma, but in addition there were lakes of epithelial mucin-containing malignant cells, i.e., mucinous (colloid) carcinoma. All four tumors expressed androgen receptors, cytokeratins, epithelial membrane antigen, gross cystic disease fluid protein-15, and carcinoembryonic antigen, but S-100 protein, other myoepithelial markers, and estrogen and progesterone receptors were negative. The mucin antigen profile showed positivity for MUC2, MUC5B, and MUC6 in all cases but only rare staining with MUC5AC and MUC7. Strong immunohistochemical overexpression of HER2/neu was demonstrated in one tumor, together with amplification by fluorescence in situ hybridization; another case was weakly positive with just one antiserum, but the remaining two tumors were completely negative. Small quantities of mucin have often been described in salivary duct carcinoma but not large extracellular mucinous lakes, which though prominent in the present series, were not as extensive as in mucinous adenocarcinoma. The relatively poor clinical outcome of the patients in our study mirrored that seen in usual-type salivary duct carcinoma and emphasizes the importance of differentiating mucin-rich salivary duct carcinoma from pure mucinous (colloid) adenocarcinoma, a tumor not fully defined, but possibly with a better prognosis.
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Huh KH, Heo MS, Lee SS, Choi SC. Three new cases of salivary duct carcinoma in the palate: a radiologic investigation and review of the literature. ORAL SURGERY, ORAL MEDICINE, ORAL PATHOLOGY, ORAL RADIOLOGY, AND ENDODONTICS 2003; 95:752-60. [PMID: 12789160 DOI: 10.1067/moe.2003.246] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Salivary duct carcinoma (SDC) is a rare, extremely aggressive malignancy arising in the ductal epithelium of the salivary glands. Radiologic investigations of and reports on minor salivary gland SDC are very rare. We present 3 cases of SDC of the palate with the attendant radiologic features and clinicopathologic findings. We also review English-language reports with radiologic findings regarding SDC and minor salivary gland SDC. MR imaging findings such as low signal intensity on T2-weighted images, infiltrative margins, and poor enhancement, in particular, should be recognized as indicators of high-grade malignancy such as SDC and, as such, should be considered when making a differential diagnosis.
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Skálová A, Stárek I, Vanecek T, Kucerová V, Plank L, Szépe P, Di Palma S, Leivo I. Expression of HER-2/neu gene and protein in salivary duct carcinomas of parotid gland as revealed by fluorescence in-situ hybridization and immunohistochemistry. Histopathology 2003; 42:348-56. [PMID: 12653946 DOI: 10.1046/j.1365-2559.2003.01600.x] [Citation(s) in RCA: 139] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
AIMS Salivary duct carcinoma is a highly malignant salivary gland tumour with aggressive clinical behaviour, characterized by histological resemblance to invasive ductal carcinoma of the breast. Amplification of HER-2/neu oncogene and over-expression of its gene product have both prognostic and therapeutic implications in breast cancer. Recent report on salivary duct carcinomas for HER-2/neu using immunohistochemistry (IHC) has shown over-expression in most cases. However, correlation between IHC and molecular genetic analysis of HER-2/neu in salivary duct carcinoma has not yet been performed. METHODS AND RESULTS We have now evaluated 11 cases of salivary duct carcinomas for HER-2/neu status using IHC and fluorescent in-situ hybridization (FISH). To our knowledge, this is the first molecular genetic analysis of HER-2/neu in salivary duct carcinoma. CONCLUSIONS In immunohistochemistry, over-expression of HER-2/neu protein was identified as distinct membrane staining in most carcinoma cells in all our salivary duct carcinoma cases, while only four cases revealed an amplification of HER-2/neu gene by means of FISH analysis. Both amplified and non-amplified salivary duct carcinomas with strong immunohistochemical staining for HER-2/neu protein were associated with poor clinical outcome for the patients. Apparently, HER-2/neu protein over-expression could also be controlled by mechanisms other than gene amplification. In the group of salivary gland tumours other than salivary duct carcinoma, strong over-expression was detected only in three cases of carcinoma ex pleomorphic adenoma. Thus, over-expression of HER-2/neu protein is also a useful marker of malignant transformation in pleomorphic adenomas.
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Affiliation(s)
- A Skálová
- Department of Pathology, Medical Faculty, Charles University, Plzen, Czech Republic.
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García-Tejeiro M, Morais D, Bachiller J, Ramírez B, Santos J. Carcinoma de conducto de stenon o stensen. ACTA OTORRINOLARINGOLOGICA ESPANOLA 2003. [DOI: 10.1016/s0001-6519(03)78464-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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de Araújo VC, Kowalski LP, Soares F, de Araújo NS, Loducca SVL, Sobral APV. Salivary duct carcinoma: cytokeratin 14 as a marker of in-situ intraductal growth. Histopathology 2002; 41:244-9. [PMID: 12207786 DOI: 10.1046/j.1365-2559.2002.01454.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
AIMS The aim of this study was to determine the immunoprofile of salivary duct carcinoma and to differentiate intraductal growth from invasive growth. METHODS AND RESULTS We applied a panel of antibodies (cytokeratins 7, 8, 13, 14, 19, vimentin and alpha-smooth muscle actin) in five cases of salivary duct carcinoma. This panel is currently used for identification of different components of salivary gland tumours in our laboratory. All tumour cells were positive for cytokeratins 7 and 8. Few neoplastic structures expressed cytokeratin 14 in cells surrounding tumour islands. CONCLUSION The finding of cytokeratin 14 was important to confirm the in-situ intraductal growth, which probably characterizes this low-grade neoplasm.
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Affiliation(s)
- V C de Araújo
- Oral Pathology Department, School of Dentistry, University of São Paulo, Universidade Estadual de Pernambuco, and Cancer Hospital AC Camargo, São Paulo, Brazil
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Lopes MA, de Abreu Alves F, Levy BA, de Almeida OP, Kowalski LP. Intraoral salivary duct carcinoma: case report with immunohistochemical observations. ORAL SURGERY, ORAL MEDICINE, ORAL PATHOLOGY, ORAL RADIOLOGY, AND ENDODONTICS 2001; 91:689-92. [PMID: 11402284 DOI: 10.1067/moe.2001.115028] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Salivary duct carcinoma is an uncommon malignant salivary gland tumor that occurs predominantly in the parotid gland. Oral involvement is extremely rare, with few cases having been reported in the literature. The tumor is characterized by an aggressive behavior and has a poor prognosis. We describe a case of salivary duct carcinoma arising in the hard palate of a 63-year-old man. Immunohistochemical analysis revealed that tumor cells tested positive for cytokeratin, epithelial membrane antigen, proliferating cell nuclear antigen, Ki67, p53, laminin, and collagen IV. Despite radical surgical resection, bilateral neck dissection, and postoperative radiotherapy, liver metastases developed, and the patient subsequently died of his disease.
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Affiliation(s)
- M A Lopes
- Oral Diagnosis, School of Dentistry of Piracicaba, University of Campinas-UNICAMP, Sāo Paulo, Brazil
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