Metastatic Adenoid Cystic Carcinoma of the Bartholin Gland.

Adenoid cystic carcinoma (ACC) of the Bartholin gland is an exceedingly rare neoplasm. A 56-year-old woman with remote ACC resection (plus neoadjuvant chemoradiation and adjuvant chemotherapy) presented to an outside institution with shortness of breath. CT showed bilateral pulmonary nodules and mediastinal lymphadenopathy. With high clinical suspicion for metastatic disease, 18 F-FDG PET/CT was performed and showed scattered nodules with mild FDG uptake along with FDG-avid mediastinal, bilateral hilar, and bilateral cervical chain lymphadenopathy. Lung biopsy of a hypermetabolic nodule confirmed metastatic ACC.