ESMO Preceptorship Programme

Zulfiyya Imamguliyeva, MD

Azerbaijan State Advanced Training Institute for Doctors named

after A.Aliyev

Baku, Azerbaijan

Parotid Tumor

Head and Neck Cancer , Zurich Switzerland, 22-23 May 2018

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Disclosures

� No disclosures

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Case Presentation

� A 21 years old young female presented with complaints

of painless enlargement of the left parotid gland since

2014.

� Physical examination revealed a firm mass in the area of

the parotid gland.

� Diagnose: Parotid tumor on the left side, pT2N0M0, stage

II

� “Histologic type” : Adenoid cystic carsinoma.

� She underwent “ Subtotal parotidectomy” on 29th of

November, 2014.

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CT-scan

Before Treatment

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Case Presentation

� Distantion radiotherapy - The patient was irradiated with 2 Gy fractions.

� Total dose was 60 Gy fractions in National Center of Oncology from 30.12.2014 to 19.02.2015.

� In October, 2015 while the patient was examined with MRI , the suspected area was identified in the I segment of Liver that was estimated to be hypertensive lesion in the size of 20x17mm. This field is being kept under dynamic control.

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Liver Metastasis

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Case Presentation

� When local relapse was notified in her next MRI check up

on 17.01.2016

� According to local relapse Removed of the parotid tumor on

the left side ,Operation was done on 12.04.16

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PET-CT scan

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Case Presentation

� June-january2016, 3cycle Docetaxel+Cisplatin

chemotherapy and Zometa 4 mg was applied to the

patient in NCO. There was not any noticeable effect.

� So, Bevacizumab was added to the treatment.

� The progression of the process was notified in

the control MRI check-up (28.10.16) at NOC.

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MRI

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Case Presentation

� December 2016-January 2017 Target and

bissfosfonat therapy lasted to applied

� In the check-up (02.02.2017) at NCO the progress of

the process increase in the size of previous

metastasis and the emergence of new recurrence

field identified

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MRI

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Case Presentation

The patient was gone through molecular genetic check up.

KRAS and EGFR mutation was not identified.

February-april 2017 According to the result of check-up 4 cycle Pantimub kg/6mg was applied

The stabilization of the process was observed in the conducted check-up.

April-june 2017 Three cycle of CAP(Cyclophosphamid+Doxorubicin+Cisplatin) and Bevacizumab kq/10mq schedule PKT was applied

During the control progress in the metastasis of liver and bones, paraximal nodule with the size of 0.6 cm suspected as metastasis in the lungs were revealed.

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MRI

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Questions

1. Local therapy on the patient: to conduct chemo

embolization of the liver metastasis?

2. To continue the treatment with metronome chemo

therapy and inhibitor ?

3. Regarding ineffectiveness of the treatment against

tumour, to reject the current treatment and to start apply

symptomatic treatment?

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Thank you for your attention!