Solitary late spinal metastasis from apocrine salivary duct carcinoma: Case report

Background: The salivary duct carcinomas (SDCs) are rare, high-grade neoplasms involving major salivary glands. Parotid is the most frequently involved gland (85%). Apocrine phenotype (histological presence of decapitation secretions) and androgen reception expression define SDC. The clinical course of these tumors is characterized by aggressive local behavior with extraglandular extension, high recurrence rates, early metastases, and poor prognoses. Despite aggressive surgical/radiation therapy management, the rates of locoregional and metastatic relapses are high, and the mortality rates over 48 months approach 65%. Notably, there is no treatment algorithm available for managing vertebral metastases from apocrine SDC. Case Description: An elderly male presented with MR/CT findings of an isolated T11 vertebral metastasis attributed to a previously treated parotid SDC. On both CT/MR, it was an osteolytic lesion and demonstrated spinal canal infiltration. The patient underwent surgical biopsy/decompression/resection, following which the lesion histopathologically proved to be a SDC. The patient was subsequently treated with 30 Gy in 10 fractions within 2 weeks of discharge. One-month later, the MRI confirmed adequate epidural decompression without recurrence, and 9 months post-operatively, patient remained disease free. Conclusion: Isolated metastasis attributed to parotid SDC followed by radiation therapy may result in tumor control.

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Fifty Years of Progress in Radiation Therapy for Breast Cancer

American Society of Clinical Oncology Educational Book ◽

10.14694/edbook_am.2014.34.21 ◽

2014 ◽

pp. 21-25 ◽

Cited By ~ 8

Author(s):

Jay R. Harris

Keyword(s):

Radiation Therapy ◽

Systemic Therapy ◽

Distant Metastases ◽

Breast Conserving Surgery ◽

Breast Conserving Therapy ◽

Adjuvant Systemic Therapy ◽

Tumor Control ◽

Axillary Lymph ◽

Recurrence Rates ◽

Term Survival

Fifty years ago, radiation therapy (RT) was only used after mastectomy in patients with high-risk disease. The equipment, treatment planning, and treatment delivery were rudimentary compared to what is available today. In retrospect, the deleterious effects of the RT back then negated its benefits. The strategy of combining lesser surgery with RT (and adjuvant systemic therapy) has been successfully employed in breast-conserving therapy (BCT) and in avoiding axillary lymph node dissection in patients with 1 or 2 involved sentinel nodes. Local recurrence rates at 10 years following BCT are now similar to those following mastectomy. RT after breast-conserving surgery and after mastectomy has been demonstrated to not only decrease local-regional recurrence but also decrease distant metastases and improve long-term survival. The development of effective adjuvant systemic therapy has made RT not only more effective but also arguably more important. If systemic therapy is effective at addressing micro-metastatic disease, then obtaining local tumor control becomes even more important. Moderately hypofractionated RT (2.66 Gy per day) is just as safe and effective as conventional fractionation shortening BCT from 6 weeks to 3–4 weeks. Treatment is now given with multiple-energy linear accelerators, CT-based simulation, 3-dimensional beam modulation for much greater dose homogeneity, on-board imaging for greater daily accuracy, and various techniques to reduce cardiac dose.

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High-dose proton-based radiation therapy in the management of spine chordomas: outcomes and clinicopathological prognostic factors

Journal of Neurosurgery Spine ◽

10.3171/2015.3.spine14716 ◽

2015 ◽

Vol 23 (6) ◽

pp. 788-797 ◽

Cited By ~ 72

Author(s):

Ronny L. Rotondo ◽

Wendy Folkert ◽

Norbert J. Liebsch ◽

Yen-Lin E. Chen ◽

Frank X. Pedlow ◽

...

Keyword(s):

Radiation Therapy ◽

Prognostic Factors ◽

En Bloc Resection ◽

Bloc Resection ◽

Tumor Control ◽

High Dose ◽

Recurrence Rates ◽

En Bloc ◽

Primary Tumors ◽

Entire Cohort

OBJECT Spinal chordomas can have high local recurrence rates after surgery with or without conventional dose radiation therapy (RT). Treatment outcomes and prognostic factors after high-dose proton-based RT with or without surgery were assessed. METHODS The authors conducted a retrospective review of 126 treated patients (127 lesions) categorized according to disease status (primary vs recurrent), resection (en bloc vs intralesional), margin status, and RT timing. RESULTS Seventy-one sacrococcygeal, 40 lumbar, and 16 thoracic chordomas were analyzed. Mean RT dose was 72.4 GyRBE (relative biological effectiveness). With median follow-up of 41 months, the 5-year overall survival (OS), local control (LC), locoregional control (LRC), and distant control (DC) for the entire cohort were 81%, 62%, 60%, and 77%, respectively. LC for primary chordoma was 68% versus 49% for recurrent lesions (p = 0.058). LC if treated with a component of preoperative RT was 72% versus 54% without this treatment (p = 0.113). Among primary tumors, LC and LRC were higher with preoperative RT, 85% (p = 0.019) and 79% (0.034), respectively, versus 56% and 56% if no preoperative RT was provided. Overall LC was significantly improved with en bloc versus intralesional resection (72% vs 55%, p = 0.016), as was LRC (70% vs 53%, p = 0.035). A trend was noted toward improved LC and LRC for R0/R1 margins and the absence of intralesional procedures. CONCLUSIONS High-dose proton-based RT in the management of spinal chordomas can be effective treatment. In patients undergoing surgery, those with primary chordomas undergoing preoperative RT, en bloc resection, and postoperative RT boost have the highest rate of local tumor control; among 28 patients with primary chordomas who underwent preoperative RT and en bloc resection, no local recurrences were seen. Intralesional and incomplete resections are associated with higher local failure rates and are to be avoided.

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Long-Term Recurrence-Free Survival After Salivary Duct Carcinoma of the Parotid: A 10-Year Follow-Up Case Report

Surgical Case Reports ◽

10.31487/j.scr.2020.08.18 ◽

2020 ◽

pp. 1-3

Author(s):

Peer W. Kämmerer ◽

D. Schneider ◽

Peer W. Kämmerer

Keyword(s):

Radiation Therapy ◽

Facial Nerve ◽

Salivary Duct Carcinoma ◽

Adjuvant Radiation ◽

Salivary Duct ◽

Duct Carcinoma ◽

Parotid Region ◽

Parotid Neoplasm ◽

The Right

Salivary duct carcinoma (SDC) represents a very rare and aggressive parotid neoplasm. A 70-year-old male was admitted to the hospital with a swelling of the right parotid region, persisting for twelve weeks. Based on sonography and contrast-enhanced computed tomography, a suspicious lesion showing mass expansion and invasion of surrounding tissues was seen. Intraoperative biopsy brought evidence of SDC. In accordance, surgical treatment included parotidectomy with preservation of the facial nerve as well as ipsilateral neck dissection due to suspicious lymphatic nodes. Afterwards, an adjuvant radiation therapy was undertaken. At 10 years of follow-up, the patient was alive and free of recurrence with full function of the facial nerve. In conclusion, keeping in mind its poor prognosis, the rare parotid salivary duct carcinoma needs aggressive therapy consisting of a surgical as well as a radiation therapy approach.

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68-Gallium-PSMA-HBED-CC PET/CT imaging for recurrent/metastatic adenoid cystic carcinoma and salivary duct carcinoma

10.1055/s-0039-1683608 ◽

2019 ◽

Author(s):

W van Boxtel ◽

S Lütje ◽

AC van Engen-van Grunsven ◽

GW Verhaegh ◽

JA Schalken ◽

...

Keyword(s):

Adenoid Cystic Carcinoma ◽

Ct Imaging ◽

Salivary Duct Carcinoma ◽

Salivary Duct ◽

Duct Carcinoma ◽

Adenoid Cystic ◽

Pet Ct

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Salivary Duct Carcinoma with Unusual Clinical Course of Sialolithiasis

Korean Journal of Otorhinolaryngology - Head and Neck Surgery ◽

10.3342/kjorl-hns.2014.57.4.251 ◽

2014 ◽

Vol 57 (4) ◽

pp. 251

Author(s):

Kyung Yeon Kim ◽

Hae Sang Park ◽

Sung Min Chung ◽

Han Su Kim

Keyword(s):

Clinical Course ◽

Salivary Duct Carcinoma ◽

Salivary Duct ◽

Duct Carcinoma

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Analysis of PD-L1 expression in salivary duct carcinoma with its efficacy as a tumor marker

Korean Society for Head and Neck Oncology ◽

10.21593/kjhno/2019.35.1.13 ◽

2019 ◽

Vol 35 (1) ◽

pp. 13-20

Author(s):

Yong Ju Lee ◽

Yoon Woo Koh ◽

Sun Och Yoon ◽

Hyang Joo Ryu ◽

Hye Ryun Kim ◽

...

Keyword(s):

Tumor Marker ◽

Salivary Duct Carcinoma ◽

Salivary Duct ◽

Duct Carcinoma

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Stereotactic radiosurgery for treating meningiomas eligible for complete resection

Radiation Oncology ◽

10.1186/s13014-021-01748-y ◽

2021 ◽

Vol 16 (1) ◽

Author(s):

Maximilian I. Ruge ◽

Juman Tutunji ◽

Daniel Rueß ◽

Eren Celik ◽

Christian Baues ◽

...

Keyword(s):

Adverse Events ◽

Stereotactic Radiosurgery ◽

Medical Condition ◽

Local Tumor Control ◽

Complete Resection ◽

Neurological Deficits ◽

Tumor Control ◽

Recurrence Rates ◽

Treatment Volume

Abstract Background For meningiomas, complete resection is recommended as first-line treatment while stereotactic radiosurgery (SRS) is established for meningiomas of smaller size considered inoperable. If the patient´s medical condition or preference excludes surgery, SRS remains a treatment option. We evaluated the efficacy and safety of SRS in a cohort comprising these cases. Methods In this retrospective single-centre analysis we included patients receiving single fraction SRS either by modified LINAC or robotic guidance by Cyberknife for potentially resectable intracranial meningiomas. Treatment-related adverse events as well as local and regional control rates were determined from follow-up imaging and estimated by the Kaplan–Meier method. Results We analyzed 188 patients with 218 meningiomas. The median radiological, and clinical follow-up periods were 51.4 (6.2–289.6) and 55.8 (6.2–300.9) months. The median tumor volume was 4.2 ml (0.1–22), and the mean marginal radiation dose was 13.0 ± 3.1 Gy, with reference to the 80.0 ± 11.2% isodose level. Local recurrence was observed in one case (0.5%) after 239 months. The estimated 2-, 5-, 10- and 15-year regional recurrence rates were 1.5%, 3.0%, 6.6% and 6.6%, respectively. Early adverse events (≤ 6 months after SRS) occurred in 11.2% (CTCEA grade 1–2) and resolved during follow-up in 7.4% of patients, while late adverse events were documented in 14.4% (grade 1–2; one case grade 3). Adverse effects (early and late) were associated with the presence of symptoms or neurological deficits prior to SRS (p < 0.03) and correlated with the treatment volume (p < 0.02). Conclusion In this analysis SRS appears to be an effective treatment for patients with meningiomas eligible for complete resection and provides reliable long-term local tumor control with low rates of mild morbidity.

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