Salivary duct carcinoma of the parotid gland: a review article

Background : Tumors of the parotid gland are a common pathology in the maxillofacial region. Most of them are benign. Some histological variants of the malignant ones, such as salivary duct carcinoma (SDC), are rare but have an extremely poor prognosis if not detected and treated early. Materials and methods : This is a review article written after analyzing information on the subject of malignant neoplasms of the parotid gland with the aim of providing a useful and systematic read, giving comprehensive information on the diagnosis, treatment, follow-up, and prognosis of these patients. It is based on the analysis of 44 medical articles (43 in English and 1 in Bulgarian). Discussion : SDC accounts for 1% to 3% of all malignant salivary gland tumors. Its etiology is currently unknown. It is characterized by rapid growth, pain, facial paralysis, and nodal metastases in a significant proportion of patients. Perineural spread is its hallmark. Clinical symptoms such as facial nerve palsy, trismus, dysphagia or foreign body sensation in the oropharynx, and ear pain are poor prognostic signs. The basis of the treatment of SDC is its early detection, its surgical removal within healthy limits, and semi-sedentary chemotherapy and radiation therapy in more advanced cases. Fine-needle aspiration biopsy and imaging studies such as computed tomography, nuclear magnetic resonance, and positron emission tomography, as well as its patho-anatomical verification, are key to its diagnosis. A complete sialadenectomy of the parotid gland as a treatment option involves the removal of the facial nerve when it is involved in the process, which leads to important psycho-emotional consequences for patients. Conclusion : Knowledge of the diagnosis, treatment, and prognosis of SDC is crucial in the management of this rare but extremely poor-prognosis parotid malignancy.