Clinical Study| Volume 20, ISSUE 11, P1533-1537, November 2013

Download started.


Clinical features of brain metastasis from salivary gland tumors


      Salivary gland tumors comprise a group of 24 tumor subtypes with a wide range of clinical behaviors and propensities for metastasis. Several prognostic factors have been identified that help predict the development of systemic metastases, most commonly to the lung, liver, or bone. Metastases to the brain are rare. To better understand the behavior of salivary gland tumors that metastasise to the brain, we performed a retrospective cohort analysis on a series of patients to highlight features of their medical and surgical management. From 2007 to 2011, a database of 4117 elective craniotomies were queried at a single institution to identify patients surgically treated for salivary gland metastases to the brain. Three patients were identified. Histologic subtypes included salivary duct carcinoma, poorly differentiated carcinoma, and papillary mucinous adenocarcinoma. They had all undergone previous treatment for their primary malignancy. The mean time to intracranial metastasis was 48 months from initial diagnosis (range, 14–91 months). Treatment for intracranial metastases included surgical resection, whole brain radiation, stereotactic radiosurgery, and chemotherapy. Intracranial metastases from salivary gland tumors are rare, present years after diagnosis of the primary tumor, and are treatable with multimodality therapy.


      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Journal of Clinical Neuroscience
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


      1. Parkin DM WS, Ferlay J, Teppo L, et al. Cancer incidence in five continents, vol. VIII. IARC Scientific Publications No. 155;2002.

        • Spiro R.H.
        Salivary neoplasms: overview of a 35-year experience with 2807 patients.
        Head Neck Surg. 1986; 8: 177-184
        • Ellington C.L.
        • Goodman M.
        • Kono S.A.
        • et al.
        Adenoid cystic carcinoma of the head and neck: incidence and survival trends based on 1973–2007 surveillance, epidemiology, and end results data.
        Cancer. 2012; 118: 4444-4451
        • Carvalho A.L.
        • Nishimoto I.N.
        • Califano J.A.
        • et al.
        Trends in incidence and prognosis for head and neck cancer in the United States: a site-specific analysis of the SEER database.
        Int J Cancer. 2005; 114: 806-816
        • Berrino F.
        • De Angelis R.
        • Sant M.
        • et al.
        Survival for eight major cancers and all cancers combined for European adults diagnosed in 1995–99: results of the EUROCARE-4 study.
        Lancet Oncol. 2007; 8: 773-783
        • Guzzo M.
        • Locati L.D.
        • Prott F.J.
        • et al.
        Major and minor salivary gland tumors.
        Crit Rev Oncol Hematol. 2010; 74: 134-148
        • Cui R.
        • Cheng X.
        • Li F.
        • et al.
        Rare cerebral and pulmonary metastases from low-grade basal cell adenocarcinoma of the parotid gland.
        Clin Nucl Med. 2011; 36: 1124-1126
        • Dawson S.J.
        • Murray R.M.
        • Rischin D.
        Hypocalcemia associated with bone metastases in a patient with salivary-gland carcinoma.
        Nat Clin Pract Oncol. 2006; 3: 104-107
        • Dequanter D.
        • Andry G.
        • Lothaire P.
        • et al.
        Wide localized excision and reconstruction for minor salivary gland tumours.
        B-ENT. 2005; 1: 187-190
        • Grisanti S.
        • Amoroso V.
        • Buglione M.
        • et al.
        Cetuximab in the treatment of metastatic mucoepidermoid carcinoma of the salivary glands: a case report and review of literature.
        J Med Case Rep. 2008; 2: 320
        • Kikuchi Y.
        • Hirota M.
        • Iwai T.
        • et al.
        Salivary duct carcinoma in the mandible: a case report.
        Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2007; 103: e41-e46
        • Pacheco-Ojeda L.
        • Domeisen H.
        • Narvaez M.
        • et al.
        Malignant salivary gland tumors in Quito, Ecuador.
        ORL J Otorhinolaryngol Relat Spec. 2000; 62: 296-302
        • Pompili A.
        • Carapella C.M.
        • Cattani F.
        • et al.
        Metastases to the cerebellum. Results and prognostic factors in a consecutive series of 44 operated patients.
        J Neurooncol. 2008; 88: 331-337
        • van der Wal J.E.
        • Becking A.G.
        • Snow G.B.
        • et al.
        Distant metastases of adenoid cystic carcinoma of the salivary glands and the value of diagnostic examinations during follow-up.
        Head Neck. 2002; 24: 779-783
        • Yamamoto H.
        • Uryu H.
        • Segawa Y.
        • et al.
        Aggressive invasive micropapillary salivary duct carcinoma of the parotid gland.
        Pathol Int. 2008; 58: 322-326
        • Barnes L.
        • Eveson J.W.
        • Reichart P.
        • et al.
        World Health Organization classification of tumors.
        IARC Press, Lyon2005
        • Maiuri F.
        • Gangemi M.
        • Giamundo A.
        • et al.
        Intracranial extension of salivary gland tumors.
        Clin Neuropathol. 2010; 29: 9-13
        • Dagrada G.P.
        • Negri T.
        • Tamborini E.
        • et al.
        Expression of HER-2/neu gene and protein in salivary duct carcinomas of parotid gland as revealed by fluorescence in-situ hybridization and immunohistochemistry.
        Histopathology. 2004; 44: 301-302
        • Skalova A.
        • Starek I.
        • Vanecek T.
        • et al.
        Expression of HER-2/neu gene and protein in salivary duct carcinomas of parotid gland as revealed by fluorescence in-situ hybridization and immunohistochemistry.
        Histopathology. 2003; 42: 348-356
        • Patchell R.A.
        • Tibbs P.A.
        • Walsh J.W.
        • et al.
        A randomized trial of surgery in the treatment of single metastases to the brain.
        N Engl J Med. 1990; 322: 494-500
        • Aoyama H.
        • Tago M.
        • Kato N.
        • et al.
        Neurocognitive function of patients with brain metastasis who received either whole brain radiotherapy plus stereotactic radiosurgery or radiosurgery alone.
        Int J Radiat Oncol Biol Phys. 2007; 68: 1388-1395
        • Kaplan M.J.
        • Johns M.E.
        • Cantrell R.W.
        Chemotherapy for salivary gland cancer.
        Otolaryngol Head Neck Surg. 1986; 95: 165-170
        • Schoenfeld J.D.
        • Sher D.J.
        • Norris Jr., C.M.
        • et al.
        Salivary gland tumors treated with adjuvant intensity-modulated radiotherapy with or without concurrent chemotherapy.
        Int J Radiat Oncol Biol Phys. 2012; 82: 308-314
        • Haddad R.
        • Colevas A.D.
        • Krane J.F.
        • et al.
        Herceptin in patients with advanced or metastatic salivary gland carcinomas. A phase II study.
        Oral Oncol. 2003; 39: 724-727