Metastasising pleomorphic salivary gland adenoma presenting as synchronous pulmonary and hepatic metastases

• Published in: BMJ case reports Vol. 2014; p. bcr2014204351
• Main Authors: Abou-Foul, Ahmad K, Madi, Mohammed, Bury, Danielle, Merritt, Anita
• Format: Journal Article
• Language: English
• Published: England BMJ Publishing Group LTD 06.06.2014; BMJ Publishing Group
• Series: Case Report
• Subjects: Adenoma, Pleomorphic; Biopsy; Cysts; Family medical history; Hospitals; Humans; Liver; Liver Neoplasms - secondary; Lung Neoplasms - secondary; Lungs; Male; Medical imaging; Metastasis; Middle Aged; Mortality; Parotid Neoplasms - pathology; Parotid Neoplasms - surgery; Salivary Gland Neoplasms - secondary; Thoracic surgery; Tumors; United Kingdom; Unusual Presentation of More Common Disease/Injury; White
• ISSN: 1757-790X; 1757-790X
• DOI: 10.1136/bcr-2014-204351

Pleomorphic salivary adenomas (PAs) are the commonest benign tumours of glandular origin in the head and neck. Occasionally PAs undergo malignant transformation to carcinoma-ex-PA and can metastasise. More rarely they metastasise without malignant transformation of the primary tumour. We present a case of a benign pleomorphic salivary gland adenoma, presenting 7 years later with multiple liver metastases and a synchronous pulmonary metastasis. Histological analysis of the lung and liver lesions confirmed a diagnosis of metastasising pleomorphic adenoma (MPA). The lung lesion was fully excised, but the multifocal nature of the liver lesions rendered them inoperable. The patient is being managed conservatively and to date has no local recurrence of the primary salivary gland tumour or any further metastases. To the best of our knowledge this is the first case of MPA with simultaneous metastasis to both lungs and liver, and also the first to describe multiple liver metastases.