Acinic cell carcinoma of the parotid gland with skull base invasion: case study, managed by exclusive external 3D radiation therapy.

OBJECTIVE To review treatment options in a rare type of parotid tumor, in a clinical case study. CASE STUDY A 62-year-old woman presenting with recurrence of acinic cell carcinoma of the parotid gland with invasion of the skull base was treated by external 3D conformational radiation, having refused large-scale exeresis. Sixty-six Gy (70Gy equivalent) were delivered in 2007. Clinical and paraclinical follow-up found regular tumor volume regression over a 2.5-year period without side-effects of radiation. DISCUSSION There are no specific data on the efficacy of external radiation therapy in acinic cell carcinoma; reports on exclusive radiation treatment of salivary gland cancer include different histological types. Exclusive radiation treatment should be at least 66-70Gy, preferably by neutron- or hadrontherapy. CONCLUSION Management of acinic cell carcinoma of the parotid is surgical with possible secondary radiation therapy; exclusive external radiation therapy is, however, an option in case of contra-indication for surgery or patient refusal.