Reactions 880 - 1 Dec 2001

SAntineoplastics

Parotid mucoepidermoid cancer in a child?: casereport

A 3-year-old boy, who was treated with antineoplastics foracute lymphoblastic leukaemia, developed parotidmucoepidermoid cancer.

The boy received induction therapy comprising 1 dose ofcyclophosphamide 1200 mg/m2, 6 doses of daunorubicin 60mg/m2, 4 doses of vincristine 1.5 mg/m2, 6 doses ofasparaginase 6000 U/m2 [frequency of administration notstated], prednisone 60 mg/m2/day for 28 days and age-adjusted intrathecal cytarabine and methotrexate [dosages notstated]. Consolidation therapy comprised 8 doses ofcytarabine 150 mg/m2, 8 doses of thioguanine 75 mg/m2, 4doses of intrathecal methotrexate 15mg and a single dose ofvincristine [dose not stated]. He then received 15 cycles ofmaintenance antineoplastic therapy comprising intrathecalmethotrexate, cyclophosphamide, thioguanine, vincristine,prednisone, IV methotrexate, cytarabine [dosages not stated],and a maximum cumulative doxorubicin dose of 300 mg/m2.The total duration of antineoplastic therapy was 30 months.

The boy had developed a 0.4cm mass in his rightretroauricular area 39 months after he completedantineoplastic therapy. Nine months later, the size of the masshad increased to 1cm, and a subtotal excision was performed.He was diagnosed with a parotid low-grade mucoepidermoidcancer. Within 10 weeks, the lesion had recurred locally. Aparotidectomy was performed; this procedure wascomplicated by tumour spillage. Histological examinationshowed grade 2 mucoepidermoid carcinoma and heunderwent radiotherapy. At follow-up 2.5 years aftercompleting radiotherapy, there was no disease recurrence.

Author comment: ‘Our patient . . . receivedcyclophosphamide and intercalating topoisomerase IIinhibitors (anthracyclines). This combination in addition toradiation has been implicated as a cause of secondary myeloidleukaemia in children treated for cancer.’Sandoval C, et al. Parotid mucoepidermoid carcinoma following chemotherapy forchildhood acute lymphoblastic leukemia. Pediatric Hematology and Oncology 18:217-220, Apr-May 2001 - USA 807205256

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Reactions 1 Dec 2001 No. 8800114-9954/10/0880-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved