Salivary duct carcinoma of the sinonasal cavity: A case report and review of the literature

BACKGROUND: Salivary duct carcinoma is a rare, aggressive tumor entity first described by Kleinsasser et al in 1968, as a group of malignant salivary gland tumors characterized by duct formation and central necrosis. A case with an unusual localization in the nasal cavity and maxillary sinus is being described in our report. METHODS: A 60-year-old patient presented with difficulty of nasal breathing and recurrent episodes of epistaxis from the left nasal cavity over the previous 3 months. On endoscopy, a vulnerable lesion in the left inferior nasal meatus could be seen. Biopsy showed salivary duct carcinoma. Treatment consisted of tumor resection by means of a combined endoscopic-osteoplastic surgical approach to the maxillary sinus, bilateral neck dissection, partial parotidectomy, and adjuvant radiochemotherapy. RESULTS: The patient is 6 months after completion of treatment and is free of disease. CONCLUSION: As salivary duct carcinoma of the sinonasal tract is extremely rare, no therapeutic standards have been developed and treatment essentially is based upon experience with ductal adenocarcinoma of the salivary glands. Surgery therapy should be radical, aiming at eradicating locoregional disease with the role of adjuvant radiotherapy lying in the management of cases with negative prognostic factors.