title: Multi-modality curative treatment of salivary gland cancer liver metastases with drug-eluting bead chemoembolization, radiofrequency ablation, and surgical resection: a case report.
abstract: BACKGROUND
  Liver metastases are rare in salivary gland tumors and have been reported only once to be the first manifestation of the disease. They are usually treated with surgical resection of the primary tumor and systemic chemotherapy. Drug-eluting bead chemoembolization has an evolving role in the treatment of hepatocellular carcinoma, as well as in the treatment of metastatic disease of the liver. Nevertheless, it has never been used in a patient with salivary gland liver metastases.
  
  
  METHODS
  We report a case of a 51-year-old Caucasian Greek woman who presented to our hospital with liver metastases as the first manifestation of an adenoid cystic carcinoma of the left submandibular gland. The liver lesions were deemed inoperable because of their size and multi-focality and proved resistant to systemic chemotherapy. She was curatively treated with a combination of doxorubicin eluting bead (DC Beads) chemoembolization, intra-operative and percutaneous radiofrequency ablation, and radiofrequency-assisted surgical resection. The patient remained disease-free one year after the surgical resection.
  
  
  CONCLUSIONS
  In conclusion, this complex case is an example of inoperable liver metastatic disease from the salivary glands that was refractory to systemic chemotherapy but was curatively treated with a combination of locoregional therapies and surgery. A multi-disciplinary approach and the adoption of modern radiological techniques produced good results after conventional therapies failed and there were no other available treatment modalities.
authors.affiliation: Department of Radiology, University Hospital of Patras, Rion, Patras 26504, Greece. andkaratzas@yahoo.co.uk.
authors.forename: Andreas
authors.initials: A
authors.lastname: Karatzas
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Katsanos
authors.forename: Ioannis
authors.initials: I
authors.lastname: Maroulis
authors.forename: Christina
authors.initials: C
authors.lastname: Kalogeropoulou
authors.forename: Evaggelos
authors.initials: E
authors.lastname: Tzorakoleftherakis
authors.forename: Dimitris
authors.initials: D
authors.lastname: Karnabatidis