Malignant pleural mesothelioma metastatic to the submandibular salivary gland, simulating glandular hypertrophy, diagnosed by fine-needle aspiration biopsy: a case report and literature review.
BACKGROUND
Malignant mesothelioma is a rare neoplasm that generally develops in the pleural or peritoneal cavity. Distant metastases are common; it rarely metastatizes to the head and neck region.


METHODS
A 54-year-old white man, a non-smoker, was treated with chemotherapy, surgery and radiation for a malignant pleural mesothelioma. Seven months after the last treatment, he developed a right submandibular enlargement: clinical examination, ultrasound and computerized tomography scans revealed a salivary gland hypertrophy. Anti-inflammatory and antibiotic treatment was then started, without improvement. An ultrasound (US)-guided fine-needle aspiration biopsy (FNAB) showed atypical mesothelial cells with nuclear enlargement and increased chromatin representation. Immunocytochemistry showed positivity for calretinin and WT-1.A diagnosis of right submandibular salivary gland involvement from mesothelioma was established, allowing an adequate treatment.


CONCLUSIONS
We report a very rare site of metastasis from malignant pleural mesothelioma. We suggest that US-guided FNAB is a useful, quick, and cheap procedure for a definite diagnosis.
Massimo
M
Ambroggi
Elena
E
Orlandi
Raoul P
RP
Foroni
Department of Oncology and Hematology, Oncology Unit, Azienda Ospedaliera 'Guglielmo da Saliceto', Via Taverna 49, 29100 Piacenza, Italy. l.cavanna@ausl.pc.it.
Luigi
L
Cavanna
D006801:Humans; D006984:Hypertrophy; D008175:Lung Neoplasms / Q000473:pathology* / Q000628:therapy; D008297:Male; D008654:Mesothelioma / Q000473:pathology* / Q000628:therapy; D000086002:Mesothelioma, Malignant; D008875:Middle Aged; D010997:Pleural Neoplasms / Q000473:pathology* / Q000628:therapy; D011379:Prognosis; D013365:Submandibular Gland Neoplasms / Q000556:secondary* / Q000628:therapy