Metastatic involvement and perforation of the appendix in a patient with parotid gland tumor treated with paclitaxel

Salivary duct carcinoma is an uncommon malignant tumor, characterized by aggressive behavior and poor prognosis. It accounts for approximately 1–3% of all malignant salivary gland tumors (2), and it is found mainly in the parotid gland, followed by the other major salivary glands (2). Histologically, salivary duct carcinoma resembles ductal carcinoma of the breast (3). Immunohistochemically, the tumor cells are positive for keratin and epithelial membrane antigen. Stains for gross cystic disease fluid protein-15 (GCDFP-15) and androgen receptor are frequently positive, but only rare expression of estrogen and progesterone receptors has been described (3). Metastases are a common feature in the evolution of parotid gland cancer. Gastrointestinal metastases, however, and especially appendicular ones, are very rare. The intrinsic nature of malignant metastases in the appendix leads to a late presentation of appendicitis with a high incidence of perforation, associated with an increased mortality and morbidity (1). We describe the case of a patient presenting as an acute abdomen because of metastatic involvement with perforation of the vermiform appendix from a salivary duct carcinoma of the parotid gland treated with paclitaxel.