Isolated Late Metastasis from Testicular Seminoma

metastasize to the parotid lymph nodes2. Extremely rare neoplasms in the head-and-neck region that have been reported to metastasize to the parotid gland include malignant hemangiopericytoma, atypical fibroxanthoma, Merkel cell carcinoma, epithelioid hemangioendothelioma, and chondrosarcoma3–5. Parotid gland metastases from carcinomas in sites not in the head and neck are rare. Among the histologic subtypes most commonly encountered are renal cell carcinoma6, breast cancer7, lung cancer8, and prostate cancer9. Rarely reported entities include adrenal neuroblastoma, rhabdomyosarcoma, leiomyosarcoma, hepatocellular carcinoma, liposarcoma, and urachus adenocarcinoma of the urinary bladder10–13. Immunohistochemistry has improved the differential diagnosis of such lesions. Germ cell tumours in the testis usually metastasize to retroperitoneal lymph nodes, lungs, liver, and brain. Other lymphatic or organ metastases are rare, especially in the headand-neck area. Nonetheless, a few cases of germ-cell neoplasia metastatic to cervical lymph nodes have been reported in the English-language literature; some of these represented the first manifestation of the primary tumour14–17. Qiu et al.18 reported the first and only case to date of seminoma metastatic to the parotid gland. Here, we present a similar rare case of a singular late metastasis from a testicular seminoma, presenting as an extensive parotid gland mass 5 years after completion of primary polychemotherapy.