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.