CLINICAL CASES   

Otorinolaringologia 2001 June;51(2):97-101

Copyright © 2009 EDIZIONI MINERVA MEDICA

language: Italian

Carcinosarcoma of the parotid gland: a case report

Tullio A., Aredia F., Corradi D.

Università degli Studi - Parma Cattedra e Divisione di Chirurgia Maxillo-Facciale Ospedale Maggiore - Parma *Dipartimento di Patologia e Medicina di Laboratorio Sezione di Anatomia Patologica

Carcinosarcoma is an extremely rare tumor of the salivary glands arising from a pre-existent pleomorphic adenoma. This is a highly malignant tumour which is clearly distinct from the more frequent carcinoma ex pleomorphic adenoma. Together with the metastasing mixed tumour, they constitute the group of mixed malignant tumours of the salivary glands. This is a rapidly developing aggressive tumour. In histological terms, it comprises a double malignat element: a sarcomatous component, usually a chrondrosarcoma, and an epithelial component, often a ductal carcinoma. These elements are also characteristics of the metastases. The overall size of the tumour is not important for prognostic purposes, while the infiltration of the malignant component for 8 mm or more is dangerous. A patient was referred to the Division of Maxillofacial Surgery at Parma and treated using total parotidectomy and laterocervical dissection. The patient then underwent adjuvant radiotherapy. He is now alive and disease-free 18 months after treatment. In this case its origin from the pleomorphic adenoma is not based on a positive medical history, as in the majority of cases reported in the literature, but on the presence of histological elements typical of the pleomorphic adenoma. It is obvious that the mixed benign tumours most susceptible to mutation are the long-standing forms or recidivations.