A case of pulmonary metastasis and local recurrence from adenoid cystic carcinoma of the submandibular gland over 20 years after the first operation is presented. The patient, an 88-year-old woman, was referred to our department in 2009 because of pain in the submandibular region. At the initial visit, a swelling measuring 20 mm in diameter was found in the right inferior border of the mandible. The patient complained of spontaneous pain and slight pressure pain. The mass was elastic hard and immobile on palpation. CT imaging showed the submandibular mass was a solid lesion enhanced generally and the border was indistinct. Her past medical history revealed that she had undergone resection of a submandibular tumor in 1986 (histological examination: adenoid cystic carcinoma) and a pulmonary tumor in 2007 (histological examination: adenoid cystic carcinoma) in another hospital. Recurrence of the submandibular gland tumor was suspected from the clinical course, and so the submandibular tumor was excised. The pathological diagnosis of the submandibular tumor was adenoid cystic carcinoma, and it was regarded as a recurrence. The postoperative course was uneventful and follow-up by our department has found no recurrence.
