gms | German Medical Science

Adenosquamous carcinoma (AC) is an uncommon malignant neoplasm with an aggressive course and an extremely poor prognosis. The appearance in the parotid gland is absolutely rare.

Case report: A 63-year-old man was admitted with a rapidly enlarging mass of the left parotideal region and an ipsilateral facial nerve palsy. Sonography and MRI verified the clinical impression of an 2,5x2x2cm intraparotideal mass. There was no evidence of cervical lymph node enlargement. A modified radical parotidectomy and ipsilateral neck dissection was performed. The histopathological examination revealed AC of the parotid gland (final tumor-classification: pT2 pN1 cM0, GIII, R0-resection). Adjuvant radiotherapy (total dose 60Gy) was applied. Six months after the initial therapy the patient was re-admitted because of local tumor-recurrence and a generalized metastasation (lung, kidney). Although a palliative chemotherapy was started immediately the patient died of the tumor three months later.

Discussion: AC represents a rare neoplasm with a clinical aggressive course. The involvement of the parotid gland in this context is very unusual, which is why such cases deserve documentation. Histologically, the AC has a marked similarity to mucoepidermoid carcinoma and adenoid squamous cell carcinoma (SCC). However, the AC presents a biphasic differentiation containing both, SCC and adenocarcinoma components. The presented case highlights the extremly aggressive biological behaviour of this neoplasm. In case of AC, we therefore recommend a radical tumor resection.