16-F93
Case 16.
A 58-year-old woman complained of gradural swelling of her right parotid gland over the preceding 8 months. Recently, she had also noted problems with "drooling" and related that her husband thought her "facial expression" had changed.
Physical examination showed a 4 cm. mass in the right parotid, which appeared to be fixed to the sorrounding soft tissue. There was also evidence of peripheral facial nerve palsy, and several superior cervical lymph nodes were also enlarged and firm. A complete right parotidectomy was performed (necessitating transection of the facial nerve), along with a regional lymphadenectomy.
Dx:
Salivary duct carcinoma
唾液腺導管癌 (Salivary duct carcinoma)
High grade epithelial S6 malignancy arising from excretory ducts
men>women, 6th-8th decade of life
#1 site - parotid gland (related to Stenger's duct)
Gross: circumscribed to infiltrative
Histo: Intraductal or infiltrating neoplasm with variety of growth patterns *comedonecrosis*
- crisriform
- solid/cystic
- papillary
- often high MF rate
- vascular/neural invasion common
DDx:
Mucoepidermoid adenoid cystic
metastatic carcinoma
Case 16.
A 58-year-old woman complained of gradural swelling of her right parotid gland over the preceding 8 months. Recently, she had also noted problems with "drooling" and related that her husband thought her "facial expression" had changed.
Physical examination showed a 4 cm. mass in the right parotid, which appeared to be fixed to the sorrounding soft tissue. There was also evidence of peripheral facial nerve palsy, and several superior cervical lymph nodes were also enlarged and firm. A complete right parotidectomy was performed (necessitating transection of the facial nerve), along with a regional lymphadenectomy.
Dx:
Salivary duct carcinoma
唾液腺導管癌 (Salivary duct carcinoma)
High grade epithelial S6 malignancy arising from excretory ducts
men>women, 6th-8th decade of life
#1 site - parotid gland (related to Stenger's duct)
Gross: circumscribed to infiltrative
Histo: Intraductal or infiltrating neoplasm with variety of growth patterns *comedonecrosis*
- crisriform
- solid/cystic
- papillary
- often high MF rate
- vascular/neural invasion common
DDx:
Mucoepidermoid adenoid cystic
metastatic carcinoma
