Acinic Cell Carcinoma (ACC) is a rare parotid gland tumor. In this case, we present F-18 fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT) images of a 75 year old male with a history of metastatic ACC. The patient was iniatially diagnosed in 2009 after he received multiple surgeries secondary to local recurrences. The patient was also treated with chemoradiation. PET/CT was performed as part of the treatment strategy evaluation. PET/CT demonstrated brain metastasis, multiple pulmonary metastatic nodules, multiple hepatic metastasis, hilar, pleural and mesenteric masses and multiple osseous metastasis. Although ACC is a low grade malignancy, it has a tendency to recur and metastasize. In this case, we report diffuse metastatic disease of ACC. Hence, we conclude PET/CT could be a very valuable tool managing the disease.
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