PMC6149030_01
Androgen deprivation therapy (ADT) and chemotherapy for a case of salivary
duct carcinoma (SDC).. (a). Computed tomography (CT) images of the lungs and parotid gland in this
patient at the timings of CT1, CT2, and CT3. See (b) for details of each
timing. (b). Tumor size (Y-axis, mm) plotted against treatment time (X-axis)
in the parotid gland and lungs analyzed by CT images. CT1, CT2, and CT3
indicate the timings in (a). TPF: docetaxel, cisplatin, and fluorouracil;
Ptx: paclitaxel; PF-Cmab: cisplatin, fluorouracil, and cetuximab.
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A computed tomography scan revealed a tumor of the parotid gland, multiple swollen neck lymph nodes, and tumors in the bilateral lungs (Figure 1). The expression of FOXA1, a pioneering factor of AR, was also observed in serial sections (Figure 2, IHC, FOXA1, pre-ADT). The tumor volumes of the parotid gland and lungs were reduced in the first 3 months after the initiation of ADT, as shown in Figures 1(a) and (b) (from CT1 to CT2). Because of regrowth of the tumors at 4 months after initiation (Figures 1(a) and (b)), docetaxel, cisplatin, and fluorouracil (TPF) chemotherapy was initiated in month 5 (Figures 1(a) and (b)).
The expression of FOXA1 is not detected after ADT in SDC case.. Hematoxylin & eosin (H & E) and immunohistochemical staining for AR
and FOXA1 before (pre-ADT) and after (post-ADT) ADT. Scale bar indicates
200 mum. IHC: immunohistochemistry.
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The tumor cells were large polygonal and contained granular eosinophilic cytoplasm, swollen and hyperchromatic nuclei, and abnormal mitosis (Figure 2, H & E, pre-ADT). AR expression was immunohistochemically positive in the nuclei of tumor cells in the lungs and neck lymph nodes (Figure 2, immunohistochemistry (IHC), AR, pre-ADT). The expression of FOXA1, a pioneering factor of AR, was also observed in serial sections (Figure 2, IHC, FOXA1, pre-ADT). AR. As shown in Figure 2, no apparent histological changes of the tumor cells were observed in specimens from the lungs and neck lymph nodes before ADT or from the parotid gland after ADT. In addition, AR expression in the parotid gland tumor was positive (Figure 2, IHC, AR, post-ADT). IHC, FOXA1, and post-ADT). Administration of leuprorelin in combination with paclitaxel was continued because of unchanged AR expression (Figure 2).