Surreal illustration of a glowing spine intertwined with a tree root system, representing rare cancer metastasis.

Spine-Chilling Discovery: How a Rare Cancer Spread to the Spine

Mira Elwood in Health & Wellness December 2025 • 4 min read.

"Unveiling the Unprecedented Case of Submandibular Gland Adenocarcinoma Metastasis to the Spine and What It Means for Early Detection and Treatment"

In the realm of medical mysteries, rare occurrences often serve as critical learning junctures, pushing the boundaries of our understanding and approaches to treatment. A recent case documented in "World Neurosurgery" details an unprecedented instance of a 50-year-old Thai male diagnosed with metastatic basal cell adenocarcinoma originating from the submandibular gland and spreading to the spine. This particular form of cancer, already rare in its primary occurrence, becomes exceedingly unusual when it metastasizes to such a distant location.

Basal cell adenocarcinomas (BCACs) are malignant neoplasms accounting for less than 1% of all salivary gland tumors. Typically, these tumors are localized, and when metastasis occurs, it rarely involves distant sites, especially the spine. This unique case not only challenges existing knowledge but also underscores the importance of considering atypical presentations in cancer diagnosis and treatment planning.

This article delves into the specifics of this remarkable case, exploring the diagnostic journey, the treatments employed, and the outcomes achieved. It also examines the broader implications for oncologists, surgeons, and patients dealing with rare cancers, highlighting the significance of early detection and innovative treatment strategies.

What Makes This Case of Spinal Metastasis So Unique?

Surreal illustration of a glowing spine intertwined with a tree root system, representing rare cancer metastasis.

The uniqueness of this case lies in the rarity of BCACs metastasizing to the spine. Medical literature has sparsely documented distant metastases of BCACs, typically noting occurrences in the lungs, liver, or skin. Spinal metastasis is virtually unheard of, making this case a crucial addition to medical knowledge. The patient's initial symptoms included a painless mass in the submandibular area, which is a common presentation for salivary gland tumors. However, the progressive weakness in both upper and lower extremities signaled a more complex underlying issue.

The diagnostic process involved a series of imaging and pathological examinations:

Physical Examination: Revealed a firm, non-movable, and tender mass measuring 10x10x5 cm³ in the left submandibular area.
Radiographs: Showed an osteolytic lesion with vertebral collapse at C6 and prevertebral soft tissue swelling.
CT Scan: Confirmed significant C6 vertebral body collapse with subaxial cervical spine subluxation.
MRI: Indicated an infiltrative intramedullary lesion at C6 vertebra with collapsed vertebral fracture.
Biopsy: Confirmed a salivary gland tumor consisting of proliferating basal cells with tubular and glandular formation.

These findings led to a diagnosis of basal cell adenocarcinoma with pulmonary and cervical spine metastases. Given the progressive myelopathy, a prompt and aggressive treatment strategy was essential.

The Road Ahead: Implications for Future Research

This extraordinary case underscores the necessity for continued research and vigilance in the diagnosis and treatment of rare cancers. By expanding our knowledge and refining our diagnostic approaches, we enhance our ability to identify and treat such unusual presentations effectively. Further studies with larger cohorts and extended follow-up periods are essential to validate these findings and improve outcomes for patients facing similar challenges. Ultimately, collaborative efforts and shared learning will pave the way for better care and improved quality of life for individuals affected by rare and aggressive cancers.

About this Article -

This article was crafted using a human-AI hybrid and collaborative approach. AI assisted our team with initial drafting, research insights, identifying key questions, and image generation. Our human editors guided topic selection, defined the angle, structured the content, ensured factual accuracy and relevance, refined the tone, and conducted thorough editing to deliver helpful, high-quality information.See our About page for more information.

This article is based on research published under:

DOI-LINK: 10.1016/j.wneu.2017.08.084, Alternate LINK

Title: Metastatic Basal Cell Adenocarcinoma Of Submandibular Gland To The Spine: An Extremely Rare Condition

Subject: Neurology (clinical)

Journal: World Neurosurgery

Publisher: Elsevier BV

Authors: Tinnakorn Pluemvitayaporn, Sombat Kunakornsawat, Chaiwat Piyaskulkaew, Pritsanai Pruttikul, Warongporn Pongpinyopap

Published: 2017-12-01

Everything You Need To Know

What is basal cell adenocarcinoma (BCAC), and why is it important to understand its behavior?

Basal cell adenocarcinoma (BCAC) is a rare malignant neoplasm that originates in the salivary glands, accounting for less than 1% of all salivary gland tumors. It is significant because, while typically localized, this case demonstrates its potential to metastasize, even to distant sites like the spine. The implications of this are that clinicians need to consider BCAC in differential diagnoses even when spinal lesions are present, and researchers need to further investigate the mechanisms of BCAC metastasis.

What makes this case of basal cell adenocarcinoma (BCAC) spinal metastasis so unusual?

The uniqueness stems from the fact that metastasis of basal cell adenocarcinomas (BCACs) to the spine is extremely rare; distant metastases are already uncommon, typically occurring in the lungs, liver, or skin. Spinal metastasis of BCAC is virtually unheard of, making this case an important addition to medical literature. This means that current understanding of BCAC metastasis might be incomplete, and there may be unidentified factors that influence its spread to unusual locations.

What were the initial symptoms that the patient presented with, and what did those symptoms indicate?

The initial symptoms were a painless mass in the submandibular area, which is a common presentation for salivary gland tumors. However, the patient also experienced progressive weakness in both upper and lower extremities. The progressive weakness signaled that the cancer may have spread to a location that affects the nervous system, which led to further investigation. It highlights that while local symptoms can point to a primary tumor, systemic symptoms may indicate metastasis and should not be overlooked.

What specific diagnostic steps were involved in identifying the spinal metastasis in this case?

The diagnostic process included a physical examination, radiographs, CT scan, MRI, and biopsy. The physical examination revealed a firm mass in the submandibular area. Radiographs showed an osteolytic lesion. A CT Scan confirmed vertebral body collapse. An MRI indicated an infiltrative lesion. A biopsy confirmed a salivary gland tumor. It underscores the importance of using a combination of imaging techniques and pathological examinations for accurate diagnosis and staging of cancer.

What are the broader implications of this case for future research and treatment of rare cancers like basal cell adenocarcinoma (BCAC)?

This case underscores the need for continued research and vigilance in the diagnosis and treatment of rare cancers like basal cell adenocarcinoma (BCAC). Further studies with larger groups of patients and longer follow-up periods are essential to validate these findings and improve outcomes for patients facing similar challenges. Collaborative efforts and shared learning are vital for advancing the understanding and treatment of rare and aggressive cancers, especially concerning the mechanisms of metastasis and the development of more effective therapies.