Bilateral parotid gland metastases from gastric signet-ring cell carcinoma

Introduction: Signet-ring cell (SRC) carcinoma is a common subtype of gastric adenocarcinoma associated with poor prognosis. Metastatic involvement of the parotid gland has been reported in gastric cancer patients, but never bilaterally nor in association with the SRC histotype. Here, we report the first case and a brief review of the literature. Case description: A 47-year-old woman was referred to our center for a signet-ring gastric carcinoma with synchronous hepatic and peritoneal metastases. After 3 lines of chemotherapy, the patient reported a progressive bilateral enlargement in the periauricolar area. An ultrasound of the salivary glands and a fine needle biopsy were diagnostic for parotid metastases of gastric origin. In the literature, only 3 cases of parotid gland metastases arising from gastric cancer are described - none with a feature of SRC carcinoma. Conclusions: To the best of our knowledge, this is the first report of gastric SRC carcinoma with bilateral parotid metastases. This case highlights the importance of considering a parotid enlargement as a possible sign of disease progression in a patient with gastric cancer. Fine-needle biopsy and immunocytochemistry are essential in establishing the origin of the secondary lesion.