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Oropharynx
Published in R James A England, Eamon Shamil, Rajeev Mathew, Manohar Bance, Pavol Surda, Jemy Jose, Omar Hilmi, Adam J Donne, Scott-Brown's Essential Otorhinolaryngology, 2022
Salivary gland cancers account for up to 6% of all head and neck malignancies. Approximately 20% of all salivary gland tumours arise in the minor salivary glands (MiSG), and they are malignant 80% of the time. The most common sites of such tumours are the hard and soft palate, and the four most common malignant subtypes are mucoepidermoid carcinoma, adenoid cystic carcinoma, adenocarcinoma, and salivary duct carcinoma. Surgical resection with adequate surgical margins is the primary treatment of choice. Post-operative radiotherapy (RT) is used, particularly in patients with high-risk factors (T3/4, close/involved margins, high-grade tumour, perineural/perivascular invasion, and N+ disease), although the radiosensitivity of MiSG cancers is highly variable.
Salivary Gland Tumors
Published in Dongyou Liu, Tumors and Cancers, 2017
Tumors of the salivary glands comprise a heterogeneous group of neoplasms with more than 24 different histologic subtypes. Of these, the most commonly occurring malignant salivary gland tumors are mucoepidermoid carcinoma (MEC, 13% of all salivary gland tumors and 35% of malignant salivary gland tumors), adenoid cystic carcinoma (ACC, 8% of all salivary gland tumors), adenocarcinoma NOS, salivary duct carcinoma, acinic cell carcinoma, and polymorphous low-grade adenocarcinoma (PLGA). The most common benign salivary gland tumors are pleomorphic adenoma (68% of all salivary gland tumors and 65% of parotid gland tumors) and Warthin tumor (or papillary cystadenoma lymphomatosum, 10% of all salivary gland tumors) [1].
Head and Neck Pathology
Published in John C Watkinson, Raymond W Clarke, Terry M Jones, Vinidh Paleri, Nicholas White, Tim Woolford, Head & Neck Surgery Plastic Surgery, 2018
Ram Moorthy, Adrian T. Warfield, Max Robinson
The malignant element of a carcinoma ex-pleomorphic adenoma typically comprises high-grade adenocarcinoma or salivary duct carcinoma often with squamoid differentiation, but other specific subtypes of salivary carcinoma are seen and these may on occasion be monotypic rather than mixed. The benign pleomorphic adenoma component can be difficult to identify, may require extensive sampling and in some cases it may never be identified. The association of pleomorphic adenoma, carcinoma and sarcoma (carcinosarcoma, true malignant mixed tumour) is very rare. Invasion of tumour through the original lesion’s capsule carries prognostic significance and has been classified as:11–13Intracapsular carcinomaMinimally invasive carcinoma (less than 4–6 mm invasion)Widely invasive carcinoma. In principle, (1) and (2) have a favourable prognosis compared to (3), although the precise cut-off point to define a category of invasion with minimal metastatic potential is controversial. Ordinarily, pleomorphic adenomas may show peripheral permeative growth, lymphatic tumour embolus, necrosis and focal internal cytonuclear atypia without signifying malignant transformation. Caution should be exercised in the interpretation of such features if prior FNAB has been attempted. Such tumours are sometimes termed ‘atypical pleomorphic adenoma’ and generally behave no differently from their more typical counterparts.
Contribution of pre-existing neoantigen-specific T cells to a durable complete response after tumor-pulsed dendritic cell vaccine plus nivolumab therapy in a patient with metastatic salivary duct carcinoma
Published in Immunological Investigations, 2022
Shu Ichimiya, Akiko Fujimura, Muneyuki Masuda, Shogo Masuda, Ryuji Yasumatsu, Masayo Umebayashi, Hiroto Tanaka, Norihiro Koya, Shinichiro Nakagawa, Poh Yin Yew, Sachiko Yoshimura, Hideya Onishi, Masafumi Nakamura, Yusuke Nakamura, Takashi Morisaki
Salivary duct carcinoma (SDC) is the most aggressive tumor among primary salivary gland cancers according to the latest World Health Organization classification (El-Naggar et al. 2017). There is no established screening method for SDC, and the disease is usually in an advanced stage at diagnosis (Nakaguro et al. 2020). No definitive treatment strategy has been established for SDC, but appropriate surgical resection and postoperative radiation therapy are recommended (El-Naggar et al. 2017; Sood et al. 2016). Chemotherapeutic strategies for SDC have not been established, but androgen receptor (AR) targeted therapy for AR-positive tumors, neurotrophic tropomyosin receptor kinase (NTRK) targeted therapy for NTRK gene fusion-positive tumors, and human epidermal growth factor receptor-2 (HER-2) targeted therapy for HER-2–positive tumors are therapeutic options (El-Naggar et al. 2017; Sood et al. 2016). Local recurrence or distant metastasis occurs in 25%–55% of cases (Alfieri et al. 2017), and the overall survival of patients who receive best supportive care for recurrence or distant metastasis is only 5 months (Boon et al. 2018). Long-lasting complete responses (CRs) are extremely rare in patients with metastatic or refractory SDC. To our knowledge, only one case, in which the patient was treated with chemotherapy, has been reported to date (Kadowaki et al. 2013). Therefore, new treatments with better efficacy against this aggressive cancer are needed.
Effects of patient-specific mobility therapy for TMJ, neck, and shoulder dysfunction after submandibular gland tumor surgery: a case report
Published in Physiotherapy Theory and Practice, 2021
Keun-Su Lee, Duck-Won Oh, Joon-Hee Lee
The patient was a 48-year-old man with pathologic diagnosis of salivary duct carcinoma, level 1b left submandibular gland tumor. He had no other relevant medical history. The tumor was 1.9 × 1.5 cm2 (T3) in size, neck node metastasis was confirmed (N2), and distant metastases were not observed. To completely remove the lesion, the operation was performed with modified RND in the left submandibular gland and lymph nodes, and the patient underwent 30 sessions of chemotherapy for two months to prevent local recurrence. After the surgery, cancer-related findings were not observed under positron emission tomography and computed tomography. However, the patient complained of limited ROM and functional impairments in the TMJ, neck, and shoulder, and was referred to a physiotherapist for further management of his functional problems five months postoperatively.
Treatment outcomes of patients with salivary duct carcinoma undergoing surgery and postoperative radiotherapy
Published in Acta Oncologica, 2020
Dong Soo Lee, Chang Geol Lee, Ki Chang Keum, Seung Yeun Chung, Taehyung Kim, Hong-Gyun Wu, Jin Ho Kim, Myung-Whun Sung, Soon-Hyun Ahn, Kwan Ho Cho, Ki Mun Kang, Young-Taek Oh, Jin Hee Kim, Min Kyu Kang
Salivary duct carcinoma (SDC) is a rare, high-grade tumor arising from the ductal epithelium of the salivary gland. SDC comprises approximately 10% of all salivary gland malignancies and typically presents in older men, with the parotid gland being the most common primary site [1]. SDC is typically managed by similar treatment approaches as other high-grade salivary gland tumors [2–4]. Complete surgical resection of the involved salivary gland and neck dissection is recommended. Postoperative radiotherapy (PORT) to the tumor bed and ipsilateral neck is usually recommended. The role of systemic chemotherapy is unclear despite its evaluation in several clinical trials [5,6]. In the prior studies, 50–70% of the patients presented with regional lymph node (LN) metastasis at initial diagnosis, and 30–70% developed distant metastasis (DM) during follow-up, resulting in 50–70% of deaths by tumor-related causes [1,7–17]. However, data describing patterns of failure after surgery and PORT have been limited so far.