title: Adenoid cystic carcinoma of submandibular salivary gland with late metastases to lung and choroid: a case report and literature review.
abstract: OBJECTIVE
  Adenoid cystic carcinoma (ACC) is a rare type of cancer that can exist in many body sites. Distant metastasis (DM) is one of the most common features of ACC, usually occurring several years after the initial diagnosis. Approximately half the patients with ACC are found to develop DM after initial treatment of the primary tumor. This report describes a case of ACC with late metastasis to the lung and choroid, which is extremely rare.
  
  
  METHODS
  A 43-year-old female patient had a history of ACC of the submandibular salivary gland. Five years after total resection and postoperation radiotherapy, distant metastases were found in the left lung and left choroid by immunohistochemistry and imaging examinations.
  
  
  RESULTS
  After radiotherapy of lesions of the lung and eye, the patient had a partial response and remained free of progression at almost 7 months.
  
  
  CONCLUSIONS
  Although many metastatic sites have been reported, currently, there are only 6 cases in the literature on ACC metastasizing to the choroid. For those patients with metastatic ACC, although modality treatments, including chemotherapy and radiotherapy, are administered, most patients have continuous metastasis and have a fatal outcome.
authors.affiliation: Medical doctor, Cancer Center, Union Hospital, Tong Ji Medical College, Huazhong University of Science and Technology, Wuhan, China.
authors.forename: Qian
authors.initials: Q
authors.lastname: Cai
authors.affiliation: Medical doctor, Professor, Cancer Center, Union Hospital, Tong Ji Medical College, Huazhong University of Science and Technology, Wuhan, China.
authors.forename: Ruiguang
authors.initials: R
authors.lastname: Zhang
authors.affiliation: Medical doctor, Professor, Cancer Center, Union Hospital, Tong Ji Medical College, Huazhong University of Science and Technology, Wuhan, China.
authors.forename: Gang
authors.initials: G
authors.lastname: Wu
authors.affiliation: Medical doctor, Professor, Cancer Center, Union Hospital, Tong Ji Medical College, Huazhong University of Science and Technology, Wuhan, China. Electronic address: xr.dong@gmail.com.
authors.forename: Xiaorong
authors.initials: X
authors.lastname: Dong
mesh_terms: D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D003528:Carcinoma, Adenoid Cystic / Q000473:pathology / Q000556:secondary* / Q000601:surgery; D002830:Choroid Neoplasms / Q000556:secondary*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008175:Lung Neoplasms / Q000556:secondary*; D018714:Radiotherapy, Adjuvant; D020266:Radiotherapy, Conformal / Q000379:methods; D012074:Remission Induction; D013365:Submandibular Gland Neoplasms / Q000473:pathology* / Q000601:surgery