Introduction Literature described a previously unnoticed bilateral approximately 4 cm measuring,
(sero) mucosal salivary gland structur in the posterolateral nasopharynx draped primarily
over the torus tubarius ("tubarial salivary gland"). PSMA-PET/CT visualized prostate-specific
membrane antigen (PSMA) positiv tissue specific for major salivary glands. Immunhistochemie
revealed predominant mucous acini, negativ amylase staining, presence of multiple
draining ducts opening in the dorsolateral pharyngeal wall.
Clinical Aspect In the reported case, a mucoepidermoid tumor was described in the localization of
the nasopharynx in 2000. In 2019 the patient presented with a recurrence of the mucoepidermoid
carcinoma in the area of the tube ostium. The tumor was already growing into the tympanum
via the Eustachian tube. In this case, surgical therapy was not possible. So definitive
radiochemotherapy with 66 Gy ad 2.2 Gy single dose, the lymphatic nodes cervical on
both sides with 54 Gy ad 2 Gy single dose and cisplatin weekly was performed. Due
to tumor progress, salvage re-irradiation with carbon ions C12 total dose 60Gy ad
3Gy single dose was carried out.
Results Mucoepidermoid carcinomas are the most common malignant tumors of the major salivary
glands. The described localization in the nasopharynx is atypical.
This case would be an indication that the "tubarial salivary gland", like the other
large salivary glands in the head and neck area, can also develop malignant degeneration.
The difficult operative accessibility of this localization requires an adaptation
of the therapy concept, especially if the standard therapy fails. For such salivary
gland tumors, in analogy to prostate carcinoma diagnosis and therapy, PSMA-labeled
radionucleotides may be considered for therapy.
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A-1241.pdf
