Non-small Cell Lung Cancer Presenting as Parotid and Scalp Swellings: A Rare Clinical Presentation

Metastases to the parotid gland as first presentation of lung cancer are extremely rare and occur in <1% cases most of which are small cell carcinomas. We present such a case of squamous cell carcinoma of the lung who presented with swellings of the parotid gland and over the scalp. He was diagnosed on the basis of fine needle aspiration cytology followed by investigative imaging to search for the primary. He was treated with palliative radiotherapy and chemotherapy but succumbed to his disease at 9 months from the diagnosis. Parotid and skin metastases in lung cancer can occur by both lymphatic and hematogenous spread. Metastases to such visible and accessible parts of the body can help in the early detection of disease, though in most cases, it occurs as a sign of progression in preexisting cancer. Management options are limited in such patients, and overall, the prognosis is poor.