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Metastatic <jats:styled-content style=\"fixed-case\">ACC<\/jats:styled-content> to the skin is even less frequent with eight previously published cases, including only one arising from the lacrimal gland. We report a case of a 61\u2010year\u2010old male, who developed multiple cutaneous metastases to the scalp and back from a lacrimal gland <jats:styled-content style=\"fixed-case\">ACC<\/jats:styled-content> 21 years after the initial diagnosis. Initially, in the absence of the past clinical history, the cutaneous lesions were interpreted as primary <jats:styled-content style=\"fixed-case\">ACC<\/jats:styled-content> of the skin. Histopathologically, the metastatic lesions were poorly circumscribed dermal and subcutaneous nodules that were composed of islands of basaloid epithelial cells with ducts and cribriform pattern, mucinous stroma and prominent perineural invasion. Histomorphologically, the cutaneous tumors were similar to the primary <jats:styled-content style=\"fixed-case\">ACC<\/jats:styled-content>. The cutaneous metastases were preceded by tumor dissemination to the lung and other visceral organs, and ultimately led to patient's demise. This report illustrates the importance of juditious clinico\u2010pathologic correlation and raises awareness regarding prolonged latency of cutaneous metastases in patients with visceral <jats:styled-content style=\"fixed-case\">ACC<\/jats:styled-content>.<\/jats:p>","DOI":"10.1111\/cup.12054","type":"journal-article","created":{"date-parts":[[2012,10,18]],"date-time":"2012-10-18T21:53:24Z","timestamp":1350597204000},"page":"341-345","source":"Crossref","is-referenced-by-count":4,"title":["Multiple cutaneous metastases: a rare and late sequelae of lacrimal gland adenoid cystic carcinoma"],"prefix":"10.1111","volume":"40","author":[{"given":"Jaroslaw","family":"Jedrych","sequence":"first","affiliation":[{"name":"Department of Pathology Yale School of Medicine  New Haven CT USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anjela","family":"Galan","sequence":"additional","affiliation":[{"name":"Department of Pathology Yale School of Medicine  New Haven CT 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