Spinal metastasis at the cervicothoracic junction from acinic cell carcinoma of the parotid gland: Case report

BACKGROUND: Acinic cell carcinoma (ACC) accounts for only 1% of all parotid neoplasms. Spinal metastases of these tumor are extremely rare. CASE DESCRIPTION: A 21-year-old patient had two prior partial resections of an ACC of the parotid gland followed by radiotherapy. Two years later, the patient presented with a 3-month history of cervicothoracic pain. The cervical spine magnetic resonance imaging revealed a pathological vertebral fracture secondary to metastatic infiltration of the D1 and D2 vertebral bodies contributing to spinal cord compression. The patient underwent a two-staged approach to resect the D1/D2 infiltrated vertebral bodies and to stabilize the cervicothoracic junction. The histopathological diagnosis was consistent with metastatic ACC. The patient subsequently received 10 cycles of adjuvant radiotherapy. Six months later, the patient was neurologically intact and radiographically exhibited adequate fusion without new tumor recurrence. At the telemedicine follow-up 35 months postoperatively, the patient was doing well without axial pain or any neurological symptoms. CONCLUSION: A 23-year-old patient following circumferential decompression/fusion of a D1/D2 metastatic parotid carcinoma ACC was neurologically symptom free and radiographically stable without evidence of residual/ recurrent tumor.