A Rare Case of Solitary Rib MetastasisThirty-Two Years after Resection ofParotid Gland Adenocarcinoma

Abstract

Context: Parotid adenocarcinoma is a rare salivary gland neoplasm, showing distant metastases in 12%-26% of cases, according to histologic grade. The most frequent locations are the cervical lymph nodes, liver, lungs and bones and metastatic disease is usually associated with poor prognosis. Single late-onset rib metastasis from adenocarcinoma of parotid gland has never been reported in the literature. Case report: We describe the case of a sixty-three-years-old male presenting with an osteolytic rib lesion 32 yrs after surgery for parotid gland adenocarcinoma. The patient was successfully treated with en bloc resection of the 11th rib for parotid gland adenocarcinoma metastasis. The patient has no evidence of local recurrence or metastatic disease 40 months after resection. Conclusion: This case may be useful for making clinical decisions because underlines the challenges of giving patients the optimal treatment considering the limited ability to predict prognosis and highlights the need for careful follow-up even in absence of recurrence for 10 yrs after curative resection.