A rare presentation of Adenoid cystic carcinoma ofparotid gland as metastatic Endobronchial growthduring Bronchoscopy with multiple ‘Bilateral Cannonball’ lung metastasis in chest radiograph

Adenoid cystic carcinoma are relatively less common type of salivary gland tumour including parotid gland, and is the only histological type having propensity to spread distantly by lympho-hematogenous and other ‘classical perineural’ spread. Adenoid cystic carcinoma as a primary salivary gland tumor arising in bronchus is known entity although is exceptionally rare. In this case report, 43 year male with past history of adenoid cystic carcinoma of left parotid gland which was operated 4 years back and received post-operative radiotherapy presented with shortness of breath clinically. We observed ‘cannon ball opacities bilaterally’ over chest radiograph and Endobronchial growth during bronchoscopy. Histopathology confirmed as a metastatic lung cancer. We recommend bronchoscopy of all the cases with bilateral cannon ball metastasis as it will help in diagnosis endobronchial growth.