Hepatic metastasis as an initial manifestation of salivary adenoid cystic carcinoma: Cytologic diagnosis

Adenoid cystic carcinoma is a malignant tumor of the salivary glands. It is slow growing and is characterized by the delayed development of distant metastasis, which may develop even a decade or more after initial treatment of the primary tumor. We present the case of a 68-year-old male with complaints and radiological findings suggestive of primary hepatocellular carcinoma. However, fine-needle aspiration findings showed metastasis of adenoid cystic carcinoma. A retrospective clinical and ultrasound examination of the patient revealed a small asymptomatic enlargement of the submandibular salivary gland that was aspirated and showed features of adenoid cystic carcinoma. Diagn. Cytopathol. 2009. © 2008 Wiley-Liss, Inc.