High-grade salivary duct carcinoma of the parotid gland - case report

A salivary duct carcinoma (histologically similar to a breast ductal carcinoma) is an uncommon high-grade, aggressive malignant tumor with frequent perineural and lymphovascular invasion. It predominantly occurs in the major salivary glands, especially the parotid gland, and may arise from a preexisting pleomorphic adenoma or de novo. This tumor shows a male predominance and is relatively uncommon in female patients. To the best of our knowledge, this is the first reported case of an ethnic Taiwanese woman with a salivary duct carcinoma. We report a case of 45-year-old woman who presented with chin pain, facial palsy, and double vision. A stony hard mass in the right parotid gland was found on the physical examination. Histopathology of the parotid tumor tissue revealed a cribriform, papillary, or solid growth pattern of neoplastic ductal epithelial cells with comedo-like central necrosis and invasive irregular glands or cords of tumor cells with a desmoplastic reaction. Metastasis of breast ductal carcinoma should be ruled out before diagnosis of a salivary gland carcinoma due to the poor prognosis of high-grade salivary duct carcinomas even with aggressive therapy. According to her clinical history and previous surgical removal of a fibroadenoma of the breast 5 years previous, ductal carcinoma of the breast was ruled out. The patient died of the disease 15 months after the diagnosis due to pulmonary and hepatic metastases. (J Dent Sci, 3(4) : 222-227, 2008)