title: Successful multimodal treatment of intraoral salivary duct carcinoma in a patient with multiple lymph node metastases: a case report.
abstract: BACKGROUND
  Salivary duct carcinoma (SDC) is a high-grade salivary gland malignancy that is associated with an aggressive clinical behavior and poor prognosis. Herein, we report on a long surviving case of SDC of the minor salivary gland with multiple lymph node metastases (LNMs).
  
  
  METHODS
  An 83-year-old woman presented with a history of lymphadenopathy in the right side of the neck and recent onset and rapid growth of a mass in the right buccal region. Clinical examinations and biopsy findings were suggestive of a salivary gland malignant tumor with regional LNMs. The patient was treated with neoadjuvant chemotherapy. Tumor excision and ipsilateral radical neck dissection were performed, followed by adjuvant chemoradiotherapy. Postoperative histological examination revealed a tumor with irregular nests of atypical ductal epithelial cells, a cribriform growth pattern, and comedo-like central necrosis that lead to a final diagnosis of SDC. LNMs were observed in six lymph nodes of the right side of the neck. The patient underwent postoperative chemotherapy using single-agent cisplatin that was administered concurrently with radiotherapy (total, 65 Gy). There was no evidence of local recurrence or distant metastasis for >6 years.
  
  
  CONCLUSIONS
  Although available data on treatment modalities for SDC remain limited, multimodal therapy may contribute to improved clinical outcomes in patients with advanced intraoral SDC.
authors.affiliation: Department of Oral and Maxillofacial Surgery, Graduate School of Medicine and Pharmaceutical Sciences for Research, University of Toyama, 2630 Sugitani, Toyama city, Toyama, 930-0194, Japan.
authors.forename: Shuichi
authors.initials: S
authors.lastname: Imaue
authors.affiliation: Department of Oral and Maxillofacial Surgery, Graduate School of Medicine and Pharmaceutical Sciences for Research, University of Toyama, 2630 Sugitani, Toyama city, Toyama, 930-0194, Japan. tomihara@med.u-toyama.ac.jp.
authors.forename: Kei
authors.initials: K
authors.lastname: Tomihara
authors.affiliation: Department of Oral and Maxillofacial Surgery, Graduate School of Medicine and Pharmaceutical Sciences for Research, University of Toyama, 2630 Sugitani, Toyama city, Toyama, 930-0194, Japan.
authors.forename: Takeru
authors.initials: T
authors.lastname: Hamashima
authors.affiliation: Department of Radiology, Graduate School of Medicine and Pharmaceutical Sciences for Research, University of Toyama, 2630 Sugitani, Toyama city, Toyama, 930-0194, Japan.
authors.forename: Gakuto
authors.initials: G
authors.lastname: Tomizawa
authors.affiliation: Department of Radiology, Graduate School of Medicine and Pharmaceutical Sciences for Research, University of Toyama, 2630 Sugitani, Toyama city, Toyama, 930-0194, Japan.
authors.forename: Kuninori
authors.initials: K
authors.lastname: Nomura
authors.affiliation: Department of Pathology, Graduate School of Medicine and Pharmaceutical Sciences for Research, University of Toyama, 2630 Sugitani, Toyama city, Toyama, 930-0194, Japan.
authors.forename: Masakiyo
authors.initials: M
authors.lastname: Sasahara
authors.affiliation: Department of Oral and Maxillofacial Surgery, Graduate School of Medicine and Pharmaceutical Sciences for Research, University of Toyama, 2630 Sugitani, Toyama city, Toyama, 930-0194, Japan.
authors.forename: Makoto
authors.initials: M
authors.lastname: Noguchi
mesh_terms: D000369:Aged, 80 and over; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis; D011379:Prognosis; D018987:Salivary Ducts / Q000473:pathology*; D012468:Salivary Gland Neoplasms / Q000556:secondary / Q000628:therapy*
keywords: Lymph node metastasis; Multimodal therapy; Salivary duct carcinoma