Adenoid cystic carcinoma is a rare malignancy with historically high mortality and morbidity, although modern surgical techniques have led to improved outcome. Often disease course is complicated by persistent local, or distant recurrence, occurring up to 10-years following initial diagnosis. Here we describe a 63 year-old female who presented with a lacrimal gland mass, which proved to be adenoid cystic carcinoma. The mass was piecemeal resected and adjuvant radiation was administered. After multiple local recurrences and resections, lung metastasis was identified ten years following initial tumor diagnosis in the lacrimal gland.

Metastatic lacrimal adenoid cystic carcinoma is rare and there is no standard approach to management of metastases. Systemic therapy has had minimal benefit, however modern targeted therapies may provide additional options. There is evidence that patients who undergo metastasectomy can have improved survival. This case highlights the need for long-term follow up of patients with adenoid cystic carcinoma as well as the need for further evaluation for effective systemic therapy options.

Metastatic Sarcomatoid Renal Cell Carcinoma has been shown to be a diagnosis that holds a median survival time of under a year. Top metastases locations have been reported to be the lung, retroperitoneal lymph nodes, and axial skeleton. Tutor markers vary widely, making the histological understanding of this disease particularly important. Whether higher percentage of sarcomatoid histopathology corresponds with a worse prognosis or not is also highly debated in the literature. Here we present a case of Sarcomatoid Renal Cell Carcinoma that has metastasized to the Duodenum, which to the best of our knowledge, is the first reported case. We hope to raise awareness of the potential duodenum metastasis and corresponding tumor markers of Sarcomatoid Renal Cell Carcinoma to aid in the treatment of future patients.

Angiomyofibroblastoma (AMF) is a rare benign neoplasm found in the genital region of both men and women. The origin of tumor growth is uncertain in males; however, reports speculate that it originates from mesenchymal cells in females. Of the reported cases, a handful displayed growth in the spermatic cord. We report a new case of AMF arising in the spermatic cord of a 68-year-old male. The mass was discovered as an incidental finding in this patient when he underwent routine removal of a hernia sac. AMF tumor has striking histomorphologic similarities to other more aggressive soft tissue tumors, such as aggressive angiomyxoma, cellular angiofibroma and myxoid types of sarcoma. Due to this morphologic similarity and generally inconclusive immunohistochemistry pattern, it is occasionally misdiagnosed as a low-grade sarcoma. We report this case to raise the awareness of pathologists and clinicians of this tumor for appropriate diagnosis and optimal management.