A Case Report and Literature Review of Metastatic Small Cell Carcinoma in Parotid Gland
Abstract
Small cell lung cancer usually presents as a progressive disease in over 70% of patients. Common organs of metastasis include the liver, adrenal glands, bones, and brain. However, metastasis to the parotid gland is uncommon, as it has been discussed only in case reports. Among all parotid tumors, small cell cancer is rare, seen in only 1.7%.A 60-year-old man presented with a slow-growing, painless tumor of the left parotid gland and peripheral facial paralysis. Neck ultrasound identified a solid mass in the left parotid gland with enlarged lymph nodes in the parotid gland and ipsilateral neck lymphadenopathies with pathologic features in levels 2 and 3. Chest computed tomography (CT) demonstrated subsegmental collapse in the lingula with peribronchial cuffing in this lobe and mild cylindrical bronchiectatic changes in the left lower lobe. CT also showed multiple
mediastinal lymphadenopa thies in prevascular, paraaortic, and paratracheal spaces. Core needle biopsy was done, and initial analysis revealed small cell carcinoma in the left parotid gland. Immunohistochemical analysis of the specimen demonstrated and confirmed the diagnosis. The patient was then referred to the radiation oncology unit for treatment. Chemotherapy was initiated with a combination of cisplatin and etoposide. No complications of the chemotherapy were observed after three cycles; treatment and follow-up are ongoing. No irradiation was performed after evaluation by the radiation oncology department. Due to the advanced stage of his disease, treatment is set for palliative purposes only. Small cell lung cancer diagnosed from solitary etastasis to the parotid gland is very rare. Physicians should keep pulmonary origin in mind when faced with a parotid tumor, as without careful examination, the primary focus may be overlooked, negatively impacting survival rates and the prognosis of the patient. Overall, this finding carries a poor prognosis, but the mainstay of treatment is palliation with systemic chemotherapy and possibly irradiation to control symptoms.
[2] Ozcan C, Talas D, Görür K. Parotid gland mucoepidermoid carcinoma associated with myasthenia gravis. J Craniofac Surg. 2007;18:1055-1058. https://doi.org/10.1097/scs.0b013e31812f8039
[3] Pointer KB, Ko HC, Brower JV, et al. Small cell carcinoma of the head and neck: an analysis of the National Cancer Database. Oral Oncol. 2017;69:92-98. doi:10.1016/j.oraloncology.2017.04.009. https://doi.org/10.1016/j.oraloncology.2017.04.009
[4] Walters DM, Little SC, Hessler RB, Gourin CG. Small cell carcinoma of the submandibular gland: a rare small round blue cell tumor. Am J Otolaryngol. 2007;28:118-121. doi:10.1016/j.amjoto.2006.06.013. https://doi.org/10.1016/j.amjoto.2006.06.013
[5] Liu M, Zhong M, Sun C. Primary neuroendocrine small cell carcinoma of the parotid gland: a case report and review of the literature. Oncol Lett. 2014;8:1275-1278. doi:10.3892/ ol.2014.2258. https://doi.org/10.3892/ol.2014.2258
[6] Servato JP, da Silva SJ, de Faria PR, Cardoso SV, Loyola AM. Small cell carcinoma of the salivary gland: a systematic literature review and two case reports. Int J Oral Maxillofac Surg. 2013;42:89-98. doi:10.1016/j.ijom.2012.10.004. https://doi.org/10.1016/j.ijom.2012.10.004
[7] Lin YC, Wu HP, Tzeng JE. Small-cell undifferentiated carcinoma of the submandibular gland: an extremely rare extrapulmonary site. Am J Otolaryngol. 2005;26:60-63. doi:10.1016/j.amjoto.2004.06.013. https://doi.org/10.1016/j.amjoto.2004.06.013
[8] Kanazawa T, Fukushima N, Tanaka H, et al. Parotid small cell carcinoma presenting with long-term survival after surgery alone: a case report. J Med Case Rep. 2012;6:431. doi:10.1186/1752-1947-6-431. https://doi.org/10.1186/1752-1947-6-431
[9] Bumpous J. Metastatic cutaneous squamous cell carcinoma to the parotid and cervical lymph nodes: treatment and outcomes. Curr Opin Otolaryngol Head Neck Surg. 2009;17:122-125. https://doi.org/10.1097/MOO.0b013e32832924e0
[10] Nuyens M, Schüpbach J, Stauffer E. Metastatic disease to the parotid gland. Otolaryngol Head Neck Surg. 2006;135:844-848. https://doi.org/10.1016/j.otohns.2006.05.010
[11] Perlikos F, Harrington KJ, Syrigos KN. Key molecular mechanisms in lung cancer invasion and metastasis: a comprehensive review. Crit Rev Oncol Hematol. 2013;87:1-11. https://doi.org/10.1016/j.critrevonc.2012.12.007
[12] Joel I. SHALOWITZ, CHARLES CASSIDY, BS, and CARL B. ANDERS. Parotid Metastasis of Small Cell Carcinoma of the
Lung Causing Facial Nerve Paralysis. J Oral Maxillofacial Surgery 1988;46:404-406. https://doi.org/10.1016/0278-
2391(88)90225-X
[13] Shuang Shi, Qi-Gen Fang, Fa-Yu Liuand Chang-Fu Sun. Parotid gland metastasis of lung cancer: a case report. World J Surg Oncol 2014;12:119. doi:10.1186/1477-7819-12-119. https://doi.org/10.1186/1477-7819-12-119
[14] Stephani C. Wang, Wei Wang and Syed Mehdi. Isolated Parotid Metastasis from Small Cell Lung Cancer. Am J Cancer Case Rep 2017;5:1-5.
[15] Yu Cui, Xiang-Yan Cui, Yu Wu. A case of metastasis of small cell lung cancer to the parotid gland: a case report
and literature review. J Int Med Res 2019;47(11):5824-5830. doi: 10.1177/0300060519865645. https://doi.
org/10.1177/0300060519865645
[16] Rulan Wang, Ting Wang and Qinghua Zhou. Parotid metastases from primary lung cancer: Case series and systematic review of the features. Thorac Oncol 2022;12:963094. doi: 10.3389/fonc.2022.963094. https://doi.org/10.3389/fonc.2022.963094
Files | ||
Issue | Vol 9 No 1 (2024): January-February | |
Section | Case Report(s) | |
DOI | https://doi.org/10.18502/crcp.v9i1.16827 | |
Keywords | ||
Parotid gland tumor Small cell cancer Lung cancer Metastasis |
Rights and permissions | |
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |