Androgen Deprivation Therapy for Intracranial Metastasis of a Salivary Duct Carcinoma: Case Report

Abstract

Salivary duct carcinoma (SDC) is a rare subtype of salivary cancers associated with androgen receptor and human epidermal growth factor receptor 2 (HER2/neu) overexpression. It shows a high propensity to give rise to distant metastases mainly to the lung, the bone, and the liver. Intracranial metastases are rare. We report the case of a 61-year-old male patient with SDC developing intracranial metastases. Unresponsive to radiotherapy and anti-HER/neu targeted therapy the intracranial metastases showed a very good partial remission to androgen deprivation therapy with goserelin acetate. This case demonstrates the potential of a highly targeted therapy with a relatively cheap and well-known drug in a patient with a rare disease without other good therapeutic options, which is a good example of modern, personalized medicine.

Keywords: Androgen deprivation; Case report; Intracranial metastasis; Salivary duct carcinoma.

Fig. 1.

a Bronchial biopsy with metastasis of the salivary duct carcinoma: HE. b Nuclear androgen receptor immunoexpression (original magnification, ×100).

Fig. 2.

Thorax CT-scan axial/transversal before (09/2020, a) and after treatment (04/2021, b).

Fig. 3.

MRI of the neurocranium T1-spin echo-sequence with contrast medium. Extra-axial mass at the left cerebellar pontine angle before (08/2020, a) and after treatment (11/2021, b).

Fig. 4.

Timeline of the main therapies and responses. P, progressive disease; PR, partial remission; SD, stable disease; Cis/Pem, chemotherapy with cisplatin and pemetrexed; ADT, androgen deprivation therapy.