Salivary gland adenoid cystic carcinoma presenting as a large metastatic hepatic mass: a case report

Authors

Matthew Walker, The George Washington University School of Medicine and Health Sciences, Washington, DC, USA.
Alisa Dewald, The George Washington University School of Medicine and Health Sciences, Washington, DC, USA.
Abdelrhman Refaey, The George Washington Transplant Institute, Department of Surgery, The George Washington University Hospital, Washington, DC, USA.
Ivan Berezowski, Department of Medicine, The George Washington University School of Medicine and Health Sciences, Washington, DC, USA.
Jacob Newman, Division of Gastroenterology, Department of Medicine, Allegheny Health Network, Pittsburgh, PA, USA.
Mamoun Younes, Department of Pathology, The George Washington University School of Medicine and Health Sciences, Washington, DC, USA.
Stephen Gray, The George Washington Transplant Institute, Department of Surgery, The George Washington University Hospital, Washington, DC, USA. stgray@mfa.gwu.edu.

Document Type

Journal Article

Publication Date

3-19-2025

Journal

Journal of medical case reports

Volume

19

Issue

1

DOI

10.1186/s13256-025-05151-z

Keywords

Adenoid cystic carcinoma; Basal cell adenocarcinoma; Case report; Cytopathology; Liver metastasis; Lung metastasis; Salivary gland tumor

Abstract

BACKGROUND: Salivary gland tumors are rare, representing 6-8% of head and neck tumors. Adenoid cystic carcinoma represents approximately 10% of salivary gland tumors. The preferential sites of metastases are the lung and bone, followed by the brain and liver. Liver metastasis as the initial clinical manifestation of parotid gland adenoid cystic carcinoma is very rare. CASE PRESENTATION: We report the case of a 29-year-old African American male patient with a metastatic salivary gland tumor who presented initially with a large hepatic mass. He complained of right upper quadrant pain and early satiety. Abdominal computed tomography revealed hepatomegaly with a large mass centered in the left lobe measuring 14 cm. A computed tomography scan revealed innumerable bilateral pulmonary nodules measuring up to 8 mm, favoring metastases. Initial histopathological examination of the liver biopsy specimens revealed a well-differentiated carcinoma characterized by a distinctive myxoid stroma, consistent with metastatic adenoid cystic carcinoma. The patient underwent transcatheter arterial chemoembolization and was discharged with a hematology-oncology follow-up. A presumptive diagnosis of stage IV adenoid cystic carcinoma with lung and liver metastases was made. The patient was given cisplatin and vinorelbine. CONCLUSION: Metastatic parotid gland adenoid cystic carcinoma with initial clinical manifestation as a liver mass is very rare and was pathologically confirmed in this patient by its histological appearance. This case emphasizes the need for clinicians to consider salivary gland tumors in the differential diagnosis of unexplained hepatic lesions.

APA Citation

Walker, Matthew; Dewald, Alisa; Refaey, Abdelrhman; Berezowski, Ivan; Newman, Jacob; Younes, Mamoun; and Gray, Stephen, "Salivary gland adenoid cystic carcinoma presenting as a large metastatic hepatic mass: a case report" (2025). GW Authored Works. Paper 6791.
https://hsrc.himmelfarb.gwu.edu/gwhpubs/6791

Department

School of Medicine and Health Sciences Student Works