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PubMed1996

Salivary duct carcinoma: a clinicopathologic study of three cases with a review of the literature.

Three cases of salivary duct carcinoma are presented. They occurred in a 60 year old man, a 66 year old man and a 57 year old woman. All of the lesions were located in the parotid gland. The tumor size ranged from 3 to 5 cm across the largest diameter. Facial paralysis was observed in two cases. Histologically, intraductal and invasive adenocarcinoma showing papillary, cribriform, and solid patterns with comedolike necrosis was observed. Immunohistochemically, the tumor cells were positive for keratin and epithelial membrane antigen. No myoepithelial cells were demonstrated within the tumor by staining for S-100 protein, alpha-smooth muscle actin or muscle specific actin. Ultrastructurally, intracytoplasmic lumina with microvilli, a moderate number of mitochrondria, lysosomes, and tight junctions were found. Regional lymph node metastasis was observed in one case, and distant metastasis developed in two cases. All of the patients were treated with adjuvant postoperative irradiation. One patient died of disease at 11 months after the initial diagnosis, another was alive with disease at 8 months, and the third patient was alive without disease at 2 years and 3 months. Salivary duct carcinoma should be differentiated from low-grade salivary gland carcinomas using morphologic and clinical criteria because of its poor prognosis even with aggressive therapy.

Adenocarcinoma↗

PubMed2003

Three new cases of salivary duct carcinoma in the palate: a radiologic investigation and review of the literature.

Salivary duct carcinoma (SDC) is a rare, extremely aggressive malignancy arising in the ductal epithelium of the salivary glands. Radiologic investigations of and reports on minor salivary gland SDC are very rare. We present 3 cases of SDC of the palate with the attendant radiologic features and clinicopathologic findings. We also review English-language reports with radiologic findings regarding SDC and minor salivary gland SDC. MR imaging findings such as low signal intensity on T2-weighted images, infiltrative margins, and poor enhancement, in particular, should be recognized as indicators of high-grade malignancy such as SDC and, as such, should be considered when making a differential diagnosis.

Adult↗

PubMed2005

Salivary duct carcinoma of the parotid gland metastasizing to the skin: a case report and review of the literature.

Salivary duct carcinomas of parotid gland are rare, as are the skin metastases from them. Four cases are reported with metastases to the skin. We present an additional case, with subcutaneous metastases of the back and leg. To our knowledge, this is the first case reported in the literature in which the nodule on an extremity was the metastasis of a salivary duct carcinoma of parotid gland.

Adult↗

PubMed1999

Dopamine stimulates salivary duct cells in the cockroach Periplaneta americana.

This study examines whether the salivary duct cells of the cockroach Periplaneta americana can be stimulated by the neurotransmitters dopamine and serotonin. We have carried out digital Ca2+-imaging experiments using the Ca2+-sensitive dye fura-2 and conventional intracellular recordings from isolated salivary glands. Dopamine evokes a slow, almost tonic, and reversible dose-dependent elevation in [Ca2+]i in the duct cells. Upon stimulation with 10(-)6 mol l-1 dopamine, [Ca2+]i rises from 48+/-4 nmol l-1 to 311+/-43 nmol l-1 (mean +/- s.e.m., N=18) within 200-300 s. The dopamine-induced elevation in [Ca2+]i is absent in Ca2+-free saline and is blocked by 10(-)4 mol l-1 La3+, indicating that dopamine induces an influx of Ca2+ across the basolateral membrane of the duct cells. Stimulation with 10(-)6 mol l-1 dopamine causes the basolateral membrane to depolarize from -67+/-1 to -41+/-2 mV (N=10). This depolarization is also blocked by La3+ and is abolished when Na+ in the bath solution is reduced to 10 mmol l-1. Serotonin affects neither [Ca2+]i nor the basolateral membrane potential of the duct cells. These data indicate that the neurotransmitter dopamine, which has previously been shown to stimulate fluid secretion from the glands, also stimulates the salivary duct cells, suggesting that dopamine controls their most probable function, the modification of primary saliva.

Animals↗

PubMed2003

Salivary duct carcinoma in the submandibular region.

A case of salivary duct carcinoma arising in the submandibular region of an 83-year-old man is presented. Histologically, the tumour consisted of solid cell nests with ductal structures. Tumour cell nests showed central comedonecrosis. Immunohistochemically, the tumour cells were positive for keratin and epithelial membrane antigen but negative for S-100 protein and calponin. Clinical features as well as pathological examinations based on haematoxylin-eosin and immunohistochemical stainings were important in the diagnosis of this case.

Aged↗

PubMed1999

Salivary duct carcinoma in five cats.

Carcinomas of salivary gland ducts are described in five cats. The typical histological pattern was the formation of large cell aggregates resembling dilated ducts, often with central necrosis and a looping pattern. All tumours were labelled with antibody to cytokeratins (CKs) 5, 6, 8, 14, 17 and 19. Labelling of tumour cells with CK14 suggested basal cell differentiation. All tumours stained with Jack bean (Canavalia ensiformis) agglutinin (Con A); this is a feature of normal salivary gland ducts but is seen in other salivary gland tumours. Staining of tumour cells at the luminal surface of ductal structures with wheat germ (Triticum vulgaris) agglutinin (WGA) in the cat tumours was similar to that seen in ducts of normal cat salivary glands but occurs in other cat tumours. Other immunohistochemical staining results were unremarkable. 1999 Harcourt Publishers Ltd.

Adenocarcinoma↗

PubMed2005

Clinical and immunohistologic typing of salivary duct carcinoma: a report of 50 cases.

BACKGROUND: Due to the low incidence of salivary duct carcinoma (SDC), only limited data in regard to the biologic behavior of this tumor and its immunohistochemical characteristics are available. The authors analyzed the clinical, molecular, and genetic profile of SDC and identified prognostic factors. METHODS: The follow-up of 50 patients with SDC was obtained and paraffin-embedded tumor samples were examined immunohistochemically. In all samples, the expression of Ki-67, HER-2, and the oncoproteins p16 and p53 was examined immunohistochemically, followed by a mutation analysis of p16 and p53. The survival rate was calculated by the Kaplan-Meier method and prognostic variables were analyzed with the log-rank test. RESULTS: SDC predominantly effected male patients (66%) in their 7th decade of life. SDC mainly occurred in the parotid gland (78%; submandibular gland, 12%; minor salivary glands, 10%). Approximately two-thirds of the patients (33 of 50) presented with a T3/T4 tumor. In 28 patients (56%), cervical lymph node metastasis was present at the time of diagnosis. Local disease recurrence was observed in 48% of patients an average of 17.4 months after initial treatment. Distant disease metastasis developed in 48% of patients an average of 29 months after initial treatment. The average overall survival period was 56.2 months. In the current study, 20.6% of the probes with positive HER-2/neu expression were (+++) positive. p53 was expressed in 83.9% of the tumor samples. In 11.8% of the tumor samples, there was a lack of p16 expression. CONCLUSIONS: Mutations of the p53 gene were more frequent in tumor samples with (++) and (+++) immunoreactivity and mainly affected exons 7 and 8. A mutation of the p16 gene was only found in 1 tumor sample. Expression of HER-2/neu and p53 was statistically linked (P < 0.05) to early local disease recurrence, distant disease metastasis, and survival rates.

Adult↗

PubMed2004

Sarcomatoid variant of salivary duct carcinoma: clinicopathologic and immunohistochemical study of eight cases with review of the literature.

Salivary duct carcinoma (SDC) is an uncommon, high-grade tumor. We present 8 cases of sarcomatoid SDC, which has been defined recently as a rare variant of SDC. The 8 patients (5 men, 3 women) had a mean age of 63.6 years. Histologically, all tumors were characterized by a biphasic neoplasm composed of both SDC and sarcomatoid elements. In 3 cases, sarcomatoid components showed osteosarcomatous heterologous differentiation. A residual pleomorphic adenoma was detected in 5 tumors. The sarcomatoid component showed focal immunoreactivity for cytokeratin in 4 cases and epithelial membrane antigen in all 8 cases. Diffuse p53 immunostaining was detected in 3 cases, and it was coexpressed in both components. Our observations support the histogenetic theory of a common origin of the carcinomatous and sarcomatoid populations. Of the 13 patients, including our 8, reported to have sarcomatoid SDC arising in a major salivary gland and for whom long-term follow-up data were available, 7 have died of disease (mean survival, 15.6 months). These results indicate that sarcomatoid SDC is a highly aggressive tumor, similar to conventional SDC.

Adenoma, Pleomorphic↗

PubMed1997

Salivary duct carcinoma: clinicopathological and immunohistochemical studies.

Nine cases of salivary duct carcinoma were reviewed clinically, histologically and immunohistochemically, with special evaluation of biomarkers with prognostic significance (p53, Ki67, c-erbB-2 and DNA content). Eight tumours occurred in the parotid gland and one in the submandibular gland. The average age of the patients (8 males and 1 female) was 62.8 years (range = 47-74 years). Tumour size ranged from 1 to 6 cm (mean = 3.46 cm). Recurrences were found in 33.3% (3 patients), regional metastases in 44.4% (4 patients) and systemic metastases in 33.3% (3 patients). Three patients died of their disease (median survival = 12.3 months), one is alive with the disease (follow-up of 222 months) and 5 are alive without evidence of disease (mean follow-up of 75 months). p53 protein nuclear immunostaining was positive in 66.6% and c-erbB-2 overexpression was observed in 100% of the tumours. Ki 67 positivity ranged from 6.75% to 47.5% of tumour cells (mean = 21.3%). DNA aneuploidy was found in 4 tumours (44.4%) and DNA diploidy in 5 (55.5%). Our results seem to indicate that Ki67 immunostaining can be useful in the evaluation of the biological behaviour of these tumours, as well as the presence of a high proliferative index of aneuploid cells and the presence of distant metastases.

Aged↗

PubMed1999

A prospective comparative study of MR sialography and conventional sialography of salivary duct disease.

OBJECTIVE: The purpose of this study was to determine the diagnostic accuracy of MR sialography in the examination of patients with salivary duct disease. SUBJECTS AND METHODS: Forty-nine patients (23 males and 26 females; 16-78 years old; mean age, 47 years) with symptoms related to the salivary glands underwent both conventional sialography and MR sialography. The latter was performed using a heavily T2-weighted, two dimensional, fast spin-echo technique and a 12-cm circular surface coil. Contiguous 3-mm axial images with frequency-selective fat suppression were acquired through the symptomatic gland. The MR sialography findings were compared with the final diagnoses determined by conventional sialography. RESULTS: Conventional sialography showed calculus disease (n = 13), stricture (n = 12), sialectasis (n = 4), cast (n = 3), neoplasm (n = 2), and normal duct (n = 16). MR sialography alone had a sensitivity of 69% in revealing calculus disease. However, the sensitivity increased to 100% when MR sialograms were combined with control radiographs. MR sialography was sufficient to accurately reveal stricture, sialectasis, and neoplasm and to direct therapy on the basis of its findings. Overall, MR sialography combined with control radiographs had a sensitivity, specificity, and diagnostic accuracy of 100%, 88%, and 96%, respectively, in revealing salivary duct abnormalities. CONCLUSION: MR sialography alone is not sufficiently sensitive to reveal salivary duct stones. Caution must be exercised when excluding calculus disease. MR sialography, when combined with control radiographs, is accurate and has the potential to replace conventional sialography.

Adolescent↗

PubMed2003

Sarcomatoid salivary duct carcinoma of the oral cavity.

This report recounts a new case of sarcomatoid variant of salivary duct carcinoma in a 45-year-old woman. The 1.5-cm polypoid mass protruded from the retromolar area and focally extended into the pharyngeal wall. The patient was free of disease for 11 years. The tumor showed a biphasic malignancy; nondescript sarcomatous proliferation predominated over ductal carcinoma population, with perceptible blending of the two components. The sarcomatoid areas had no heterologous properties. Discohesive pleomorphic cells were immunopositive for vimentin, epithelial membrane antigen and AE1/AE3 at a significant rate. A dual expression of AE1/AE3 and vimentin was also evident in enmeshed foci of conventional cribriform adenocarcinoma. Thus, the sarcomatoid histology represents a dedifferentiated phenotype of salivary duct carcinoma.

Biomarkers, Tumor↗

PubMed1994

Introduction of a new diagnostic procedure: salivary duct endoscopy (sialendoscopy) clinical evaluation of sialendoscopy, sialography, and X-ray imaging.

The diagnosis of obstructive salivary duct disorders to date has been based on imaging by roentgenography and ultrasound, which do not always yield a precise diagnosis. Sialendoscopy is a new procedure for identifying the cause of obstructive symptoms with direct inspection of the efferent salivary duct system by means of a microendoscope. This new technique does not impose a strain on the patient and is performed under local anaesthesia on an outpatient basis.

Endoscopy↗

PubMedDate not supplied

Salivary duct carcinoma--a clinicopathologic study of 12 cases.

Salivary duct carcinoma (SDC), a recently defined malignant tumor usually of major salivary glands, has probably been included in the group of adenocarcinomas, NOS. As yet, only a few descriptions of its clinical behavior have appeared. We have found 12 cases of SDC treated at our institution since 1970 and have reviewed their presentation and course. Despite total parotidectomy in most cases and radiotherapy in all, most patients have succumbed to their tumors, six with distant metastases. SDC appears to be a highly malignant tumor requiring aggressive combined therapy for locoregional control. The high incidence of systemic spread indicates a need for effective chemotherapy on an adjuvant basis.

Adenocarcinoma↗

PubMed2004

Adenoid cystic carcinoma associated with salivary duct cyst in the sublingual gland.

We described an extremely rare case of adenoid cystic carcinoma associated with salivary duct cyst in the sublingual gland of a 40-year-old Japanese woman. The tumor was growing from the cyst wall and almost occluded the cyst lumen. The epithelium lining the cyst lumen contained both keratin 19-positive cells and alpha-smooth muscle actin-positive cells, indicating the cyst being derived from the acinus/intercalated duct of the sublingual gland. Therefore, our case has presented for the first time a direct evidence that adenoid cystic carcinoma arises from acinus/intercalated duct.

Adult↗

PubMed1998

Salivary duct carcinoma ex pleomorphic adenoma: analysis of the findings in fine-needle aspiration cytology and histology.

Salivary duct carcinoma (SDC) is an uncommon and highly aggressive neoplasm that reveals histopathologic features resembling infiltrating duct carcinoma of the breast and prostate. SDC arising on the basis of preexisting pleomorphic adenoma (PA) is very rare. This report describes the fine-needle aspiration (FNA) cytology of a case of SDC ex PA. FNA smears were cellular with cells with large, pleomorphic nuclei, some prominent nucleoli, and finely vacuolated cytoplasm. The neoplastic cells were forming groups, sheets, and papillary structures and a cribriform pattern was present in some sheets. Mitotic figures were frequently seen. Necrosis was prominent in the background. Histologic sections of the tumor revealed areas of comedo carcinoma, papillary carcinoma, and infiltrative carcinoma as well as multiple foci of PA. The presence of a cribriform pattern, tumor cells resembling breast ductal carcinoma cells, and a necrotic background are helpful features for an accurate cytodiagnosis of SDC.

Adenocarcinoma↗

PubMed1999

Metastatic salivary duct carcinoma to the uterus: report of a case diagnosed by cervical smear.

Metastasis to the uterus from extragenital sites is uncommon. We report on a rare case of salivary duct carcinoma (SDC) of the parotid gland with metastasis to the uterus, diagnosed by cervical smear. To the best of our knowledge, this is the first case reported in the literature. A 61-yr-old woman with a prior diagnosis of SDC was admitted to hospital with a fractured left humerus, back pain, and vaginal bleeding. A cervical smear and an endometrial aspiration were performed. The cervical smear showed numerous fragments and many isolated tumor cells in a clean background. The tumor cells were large and had abundant, granular/vacuolated cytoplasm. The nuclei were slightly pleomorphic, with fine chromatin and 1-2 small nucleoli. The malignant cells were morphologically identical to the primary tumor and correlated with the tumor in the endometrial aspiration. A diagnosis of metastatic salivary duct carcinoma was made. Although metastatic SDC to the uterus is rare, this possibility should be considered in the differential diagnosis of a positive cervical smear. This case also illustrates the importance of appropriate clinical history, including the knowledge of a primary tumor which may prevent unnecessary clinical investigations. Diagn. Cytopathol. 1999;21:271-275.

Carcinoma↗

PubMed2026

Human Epidermal Growth Factor Receptor-2 positive metastatic salivary duct carcinoma with remarkable response to targeted therapy: a case report and therapeutic implications.

Salivary duct carcinoma (SDC) is a rare and highly aggressive malignancy that frequently overexpresses Human Epidermal Growth Factor Receptor 2 (HER2). Despite the increasing recognition of HER2-targeted strategies, evidence remains limited and largely derived from small trials and case series. We report the case of a middle-aged man with HER2-positive metastatic SDC who achieved near-complete pathologic and radiological response to trastuzumab and docetaxel, enabling surgical resection for locoregional control. This case highlights the role of anti-HER2 therapy as a first-line strategy in SDC and underscores the importance of individualized management plans integrating systemic treatment and locoregional measures.

Humans↗

PubMed1979

[Sodium transport and potassium excretion by the salivary ducts of the dog's submandibular gland (author's transl)].

In order to study the possibility of the existence of a threshold for the transport capacity for sodium by the salivary ducts of the dog's submandibular gland 10 mongrel dogs were rendered hypernatremic by the intravenous infusion of a hypertonic sodium solution. The main excretory duct was canulated and the vegetative branch of the chorda tympani nerve was maximally excited for 20-minute periods intercalated by similar periods of rest. A threshold for sodium transport was observed, dependent on the amount of sodium offered to the salivary ducts and on the salivary flow. This threshold is around 75 uEq/min with a flow of saliva of 1.3 ml per minute. The excretion of potassium in these experiments did not show a trend to reach a threshold.

Animals↗