Primary large cell carcinoma of the submandibular gland

A rare case of primary large cell carcinoma of the submandibular gland is reported. A 53-year-old man presented with a tumor in the left submandibular region extending to the supraclavicular fossa. After unsuccessful radiochemotherapy at another hospital, he was referred to our department for combined therapy of radiation, hyperthermia, and intraarterial anticancer drug infusion. Although the local tumor decreased in size after therapy, the patient died of respiratory insufficiency due to rapid progression of pulmonary metastases. Autopsy showed that tumor cells in both the submandibular gland and the lung were compatible with undifferentiated large cell carcinoma without tubular formation or laminar structure. The submandibular tumor was considered to be the primary site because cicatricial tissue surrounding the lesion suggested that had formed over a long period. The pulmonary lesions were considered to be metastases because necrosis and intravascular carcinoma cell embolism were noted. The above findings led to the final diagnosis of primary large cell carcinoma of the submandibular gland with pulmonary metastases. This condition has rarely been reported in the literature.