Salivary Duct Carcinoma: A Rare Entity

Salivary duct carcinoma (SDC) is a rare malignancy that most commonly affects males in the fifth and sixth decades of life. Patients commonly present with a fast-growing form mass, often around the facial nerve. There are no known etiologic factors. Their most peculiar feature is morphological and immunohistochemical similarity to ductal carcinoma of the breast. Therapeutic approach is non-consensual because of the limited data but an extensive surgical resection has been advocated, along with postoperative chemoradiation in selected cases. Antiandrogen therapy may be useful in patients with advanced SDC. The rate of locoregional recurrence is high and the prognosis for survival is poor. We present the case of a 43 years-old patient with a right parotid lump of small dimension and rapid growth. Facial nerve deficits were not apparent and neck palpation identified no enlarged lymph nodes. MRI described a small lesion of oval shape and well defined contours. Fine-needle aspiration biopsy raised the possibility of a myoepithelial tumour and a superficial parotidectomy was performed. The patient experienced no complications during the postoperative healing. There were no facial nerve deficits. Microscopic examination concluded to a SDC. It was decided by a multidisciplinary team to apply radiation therapy to the surgical bed. At two years of follow up the patient remains with no clinical or imagological evidence of tumour recurrence.