Metastasis to the submandibular gland as the initial presentation of small cell ("oat cell") lung carcinoma

A 45-year-old man had a submandibular mass, which was resected. Histopathologic evaluation and the subsequent course revealed it to be a metastasis from a small cell carcinoma of the lung. This is the first case in which a metastatic lesion in the submandibular gland was the presenting manifestation of an extrasalivary neoplasm, predating discovery of the primary tumor. Metastases to the salivary glands in general and to the submandibular gland in particular are discussed, as is the differential diagnosis with primary salivary gland carcinoma.