Salivary duct carcinoma of the parotid.

INTRODUCTION

Salivary duct carcinoma is one of the rarest and most aggressive forms of parotid tumor. We report two cases.

CASES: Case 1: a 78-year-old man was referred for a salivary duct carcinoma of the left parotid gland. Treatment was surgical (parotidectomy with ipsilateral selective neck dissection), without capsule rupture, and with healthy margins. At seven years' follow-up, the patient was alive and disease-free. Case 2: a 41-year-old man was referred for a salivary duct carcinoma of the left parotid gland. Parotidectomy with ipsilateral selective neck dissection left healthy but insufficient margins (<1 cm), and postoperative radiation therapy (70 Gy) was undertaken. At eight years' follow-up, the patient was alive and free of recurrence.

DISCUSSION: Mean patient age in the literature is 60 years, with a male-to-female ratio of 2:1. Mean five-years' recurrence-free survival was 34%.

CONCLUSION

Surgery is the main form of treatment in this indication. Postoperative radiation therapy is indicated in case of extraparotid extension, pathological resection margins, cervical lymph node metastasis, lymphatic embolus and/or neurologic invasion. Chemotherapy is generally reserved for metastatic forms of the disease.