Adenoid cystic carcinoma metastatic to the dura: report of two cases.

Adenoid cystic carcinoma (ACC) originating in the salivary and lacrimal glands usually spreads to the intracranial space by following cranial nerves into the cavernous sinus, temporal bone and cerebellopontine angle. We present two cases in which ACC metastasized extensively to the dura, suggesting that ACC has an affinity for the dura. Case 1, a 43-year-old man, was operated on 12 years earlier for invasive ACC of the right palate. He experienced recurrence of the tumor in the left cavernous sinus and sella, and extensive involvement of the dura of both right and left temporal fossae. Case 2, a 33-year-old woman, had spread of ACC to the right convexity dura and tentorium after undergoing a resection of a left-sided ACC tumor of the lacrimal gland two years earlier. Both patients underwent multiple resections and radiation treatment. Extensive, multifocal, bilateral spread of ACC to the dura in both cases indicates that ACC has an affinity for the dura.