Small Cell Lung Cancer Diagnosed With Metastasis in Parotid Gland

Among all parotid gland tumors, small cell cancer is rare, seen in only 1.7%. Tumoral findings in the parotid gland may sometimes be caused by metastasis, and diagnosis in these patients may be made at this metastatic focus. A 59-year-old male patient presented with a 3 x 4-cm painless mass in front of the mandibula. A malignant epithelial tumor was diagnosed after the histopathologic examination of the fine-needle aspiration biopsy specimen. The patient did not give consent for urgent parotidectomy. One month later, he presented again, indicating the growth of the mass. On the examination, it was noted that the mass had enlarged and become ulcerated. Incisional biopsy was applied for this lesion. The biopsy material revealed small cell cancer. Scanning of other systems was performed with the suspicion of a metastatic tumor, which revealed a mass with an undefined border separating it from the right main bronchus and numerous hypodense focuses in the patient's liver on thoracoabdominal computed tomography. In addition to the multiple metastatic focuses in the cranium, there were multiple bone metastases in the vertebra and the proximal parts of the bilateral femurs on bone scintigraphy. Due to bronchoscopy, an endobronchial lesion was seen on the right upper lobe bronchus, the biopsy material obtained from this area was diagnosed as small cell lung cancer. This case was presented because of its rarity as a first diagnostic site. Parotid gland small cell cancer metastasis from the lung is rare, and if a careful examination is not performed, primary focus may be overlooked, negatively affecting the lifetime survival rate and the prognosis of the patient.