Carcinoma de ducto salivar: comportamento biológico e expressão de metalotioneína em 33 casos do Instituto Nacional de Câncer

Abstract

Salivary duct carcinoma (SDC) is a high grade malignancy which resembles ductal carcinoma of the breast. The aim of this present study was to review the recent experience with SDC at the Brazilian National Cancer Institute, comparing demographic, histological, prognosis and therapeutic with the international literature. Medical files of 33 cases identified from 1996 to 2006 were assessed to gather data of interest. Is was observed that most patients were man, aged over 50 years-old, with tumors in parotid, usually showing symptoms. Two patients presented with bilateral SDC. Histologically, neural and vessels invasion were commonly observed, but it was not associated with symptoms or metastasis. More than half patients died, mostly because distant metastasis. Regional or distant metastasis, involvement of surgical margins, and absence of comedonecrosis were associated to worse prognosis. Patients were treated with by surgery, associated or not with postoperative radiotherapy, but the therapeutic alternative was not associated with better outcome. Expression of metallothionein was low but metastasizing tumors presented significantly higher indexes of staining. In conclusion, this study confirmed the distinct features of SDC, in particular its remarkable aggressiveness, and call attention for the need for new therapeutic approaches, especially to prevent and treat metastatic disease.