RESUMO
The prevalence of primary hyperparathyroidism (PHPT) is increasing as routine laboratory testing for calcium and parathyroid hormone becomes more prevalent due to heightened awareness of the disease. PHPT affects multiple organ systems including the cardiovascular system. This case report highlights a patient with first degree atrio-ventricular block pre-operatively that resolved after resection of her parathyroid adenoma. This case emphasizes the importance of treating asymptomatic hyperparathyroidism to optimize cardiac function.
RESUMO
BACKGROUND: Salivary duct carcinoma (SDC) is an aggressive tumor of the head and neck with a poor prognosis. The objective was to study SDC and recommend the use of trastuzumab as adjuvant therapy. METHODS: A retrospective chart review of patients seen between 1993 and 2006 was performed. Tumor specimens were examined for HER-2 protein overexpression via immunohistochemistry (IHC) and fluorescence in situ hybridization (FISH) methods. RESULTS: Of the 7 patients with SDC, 57% had tumors arising in the parotid gland, the majority having facial nerve paralysis, 71% with nodal disease, and 43% having recurrence. All samples were HER-2 positive on IHC. Three patients had FISH-positive tumors, recurrent disease, and received trastuzumab therapy; 1 of the 3 died after 20 months and a second has shown disappearance of metastatic disease. CONCLUSIONS: Trastuzumab is effective in treating HER-2-positive breast cancer. Given immunohistochemical similarities between SDC and ductal carcinoma of the breast, patients with FISH-positive HER-2/neu SDC should be considered for trastuzumab therapy.