An unusual case of spleen metastasis from carcinoma ex pleomorphic adenoma of the parotid gland.
Carcinoma ex pleomorphic adenoma is a rare tumor arising from the salivary glands that spreads through direct extension, through the lymphatic vessels, and, rarely, hematogenously. When distant metastases have been found, they have been reported mainly in the lung. We present an unusual case of carcinoma ex pleomorphic adenoma of the parotid gland with splenic metastases. The patient presented with a primary carcinoma ex pleomorphic adenoma of the parotid gland and he underwent a total parotidectomy with laterocervical lymphadenectomy ipsilateral and adjuvant radiation therapy to the right parotid area. One year later, the patient showed an ipsilateral supraclavicular lymph node recurrence, treated with surgery and radiation therapy. Two more years later, the patient developed lung and splenic lesions, detected through CT and PET. He underwent splenectomy and pathologic assessment of the specimen showed metastatic carcinoma ex pleomorphic adenoma. To our knowledge, there is no reported case of a carcinoma ex pleomorphic adenoma metastasizing to the spleen. Patients treated for carcinoma ex pleomorphic adenoma should be investigated for distant metastases with a long-term follow-up examination for local and distant metastases and new splenic lesions in these patients should be investigated.
Department of medico-surgical sciences and biotechnologies, Faculty of Pharmacy and Medicine, "Sapienza" University of Rome, Oncology Unit, ICOT, Via Franco Faggiana, 1668, 04100 Latina, Italy. dr.rossi@ymail.com.
Luigi
L
Rossi
Erika
E
Giordani
Antonella
A
Fontana
Claudio
C
Di Cristofano
Giuseppe
G
Cavallaro
Oreste
O
Bagni
Luca
L
Filippi
Loredana
L
Bianchi
Giulia
G
Rinaldi
Francesca Perrone
FP
Congedi
Anselmo
A
Papa
Davide
D
Caruso
Monica
M
Verrico
Gianfranco
G
Silecchia
Silverio
S
Tomao
D000230:Adenocarcinoma / Q000473:pathology* / Q000601:surgery; D008949:Adenoma, Pleomorphic / Q000473:pathology* / Q000601:surgery; D000368:Aged; D006801:Humans; D008297:Male; D010307:Parotid Neoplasms / Q000473:pathology* / Q000601:surgery; D011379:Prognosis; D013160:Splenic Neoplasms / Q000556:secondary* / Q000601:surgery