A Case of Small Cell Carcinoma of the Submandibular Gland Successfully Treated with Multidisciplinary Therapy

Abstract

The majority of all small cell carcinomas originate in the lungs, and small cell carcinomas of extrapulmonary origin are rare. Small cell carcinomas originating in the head and neck region account for approximately 10% of all extrapulmonary small cell carcinomas. We report our experience with a case of small cell carcinoma of the submandibular gland.

A 48-year-old woman was referred to our department with a suspected submandibular gland tumor. Computed tomography and magnetic resonance imaging of the neck revealed marked swelling of the right submandibular gland with a heterogeneous internal structure. Lymphadenopathy was observed in the right submandibular and supraclavicular regions. Fluorodeoxyglucose positron emission tomography revealed accumulation in the right submandibular gland and lymph nodes, and in the inferior-medial deep cervical lymph nodes. Based on the findings, total excision of the right submandibular gland with radical right neck dissection was performed immediately. Based on the results of hematoxylin-eosin staining and immunological staining of resected specimens, we made the final diagnosis of primary small cell carcinoma of the submandibular gland. Metastases were detected in the right submandibular lymph nodes and inferior-medial deep cervical lymph nodes (T3N2bM0); therefore, after the surgery, the patient was administrated five cycles of etoposide and cisplatin chemotherapy (100 mg/m² etoposide and 80 mg/m² cisplatin). Postoperative radiotherapy (60 Gy) was applied to the neck. Five years post-treatment, the patient remains under observation, without any sign of recurrence. In case of primary salivary gland small cell carcinoma where the tumor is resectable, we recommend surgery and application of multimodal therapy, including chemotherapy and radiotherapy, consistent with the recommendations for the treatment of pulmonary small cell carcinoma.