# White out hemithorax secondary to salivary gland type of lung cancer with metastasis in liver and bone: a case report

## TL;DR

A rare case of salivary gland-type lung cancer in a nonsmoker is reported, highlighting its aggressive nature and poor prognosis despite palliative treatment.

## Contribution

This case report adds to the limited literature on salivary gland-type lung carcinomas, emphasizing their clinical presentation and management challenges.

## Key findings

- The patient presented with a rare salivary gland-type lung carcinoma (adenoid cystic carcinoma) with no smoking history.
- The tumor was inoperable due to major vessel invasion and resulted in death within 2 months of diagnosis despite palliative treatment.

## Abstract

Salivary gland-type lung carcinomas are uncommon neoplasms of the lung, representing less than 1% of all lung tumors. The two most common among them are adenoid cystic carcinoma and mucoepidermoid carcinoma. Although they usually have an indolent behavior, adenoid cystic carcinomas can be more aggressive, with 5-year survival as low as 55%. Very few cases are reported in literature. We report a similar rare case of salivary gland type lung carcinoma that presented for the first time with unilateral opacification of left hemithorax.

A 38-year-old man of North Indian origin, who was a a nonsmoker, presented with complaints of shortness of breath and cough for 1 year, which has increased in the last 2 months and was associated with significant weight loss. A frontal radiograph of the chest and computed tomography of the chest were performed, which showed a mass in the left upper lobe of the lung with its epicenter in the left main bronchus. A bronchoscopic guided biopsy was performed, and histopathology confirmed the diagnosis of lung carcinoma of salivary gland type (adenoid cystic carcinoma). There was invasion of major vessels, hence the patient was offered and started on palliative management instead of surgical treatment.

In spite of palliative management of two cycles of chemotherapy and radiotherapy, the patient succumbed to the disease within 2 months from the time of diagnosis.

Lung carcinoma of the salivary gland type (especially adenoid cystic carcinoma) usually presents at a later stage. The resectability of the tumor depends on the involvement of the surrounding major vessels. Interestingly, these cancers have no association with smoking. The prognosis depends on the extent of the disease at the time of diagnosis. Hence, imaging plays a major role in deciding the further plan of management.