Carcinoma ex
pleomorphic adenoma is a rare
tumor arising from the salivary glands that spreads through direct extension, through the lymphatic vessels, and, rarely, hematogenously. When distant
metastases have been found, they have been reported mainly in the lung. We present an unusual case of
carcinoma ex
pleomorphic adenoma of the parotid gland with splenic
metastases. The patient presented with a primary
carcinoma ex
pleomorphic adenoma of the parotid gland and he underwent a total parotidectomy with laterocervical
lymphadenectomy ipsilateral and adjuvant
radiation therapy to the right parotid area. One year later, the patient showed an ipsilateral supraclavicular lymph node recurrence, treated with surgery and
radiation therapy. Two more years later, the patient developed lung and splenic lesions, detected through CT and PET. He underwent
splenectomy and pathologic assessment of the specimen showed metastatic
carcinoma ex
pleomorphic adenoma. To our knowledge, there is no reported case of a
carcinoma ex
pleomorphic adenoma metastasizing to the spleen. Patients treated for
carcinoma ex
pleomorphic adenoma should be investigated for distant
metastases with a long-term follow-up examination for local and distant
metastases and new splenic lesions in these patients should be investigated.