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83rd Annual Meeting of the German Society of Oto-Rhino-Laryngology, Head and Neck Surgery

German Society of Oto-Rhino-Laryngology, Head and Neck Surgery

16.05. - 20.05.2012, Mainz

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Salivary duct carcinoma, an uncommen differential diagnosis of malignant sinunasal tumors: Off-label use of Bicalutamid in androgen receptor positive tumors

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  • corresponding author presenting/speaker Ferdinand Bischof - Universitätsklinik für Hals-Nasen-Ohrenheilkunde, Ulm, Germany
  • Christian Bermüller - Universitätsklinik für Hals-Nasen-Ohrenheilkunde, Ulm, Germany
  • Gerhard Rettinger - Universitätsklinik für Hals-Nasen-Ohrenheilkunde, Ulm, Germany

German Society of Oto-Rhino-Laryngology, Head and Neck Surgery. 83rd Annual Meeting of the German Society of Oto-Rhino-Laryngology, Head and Neck Surgery. Mainz, 16.-20.05.2012. Düsseldorf: German Medical Science GMS Publishing House; 2012. Doc12hno17

doi: 10.3205/12hno17, urn:nbn:de:0183-12hno178

Published: July 23, 2012

© 2012 Bischof et al.
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Outline

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Salivary duct carcinomas are uncommon tumors of the head’s major salivary glands. They are characterized by their aggressive behaviour, disposition to metastasize and their high risk for tumor recurrence. Mostly males from 60 years on are affected. The therapy of choice is complete tumor resection and postoperative chemotherapy.

Here we report about an uncommon localization of a salivary duct carcinoma in the main nasal cavity of a 96-year old female patient, which was identified after functional endoscopic sinus surgery (FESS). The histological diagnosis showed a small cell carcinoma with pleomorphic nuclei, which is characteristic for salivary duct carcinoma. Immunhistochemically androgen receptor has been shown on about 50% of the tumor cells, whereas epithelial growth factor (EGFR) only on 20% of the cells. Her2neu has not been proven.

Despite of the R2-situation and the high risk of metastasis formation we decided with respect to he patient’s high age not to perform any operative revision or chemotherapy. Being aware of the high risk of metastasis formation we have chosen an antiandrogen therapy with the drug Bicalutamid, which has been successfully used in prostatic cancer therapy.

Salivary duct carcinoma is therefore an uncommon but possible differential diagnosis of sinunasal tumors. New therapy options are target drugs, e.g. antiandrogen drugs, which selectively block their target protein or receptor.