Parotid Tumor - European Society for Medical Oncology · ESMO Preceptorship Programme...
Transcript of Parotid Tumor - European Society for Medical Oncology · ESMO Preceptorship Programme...
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
ESMO PRECEPTORSHIP PROGRAMME
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.
ESMO PRECEPTORSHIP PROGRAMME
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.
ESMO PRECEPTORSHIP PROGRAMME
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
ESMO PRECEPTORSHIP PROGRAMME
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.
ESMO PRECEPTORSHIP PROGRAMME
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
ESMO PRECEPTORSHIP PROGRAMME
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.
ESMO PRECEPTORSHIP PROGRAMME
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?