The regional lymph nodes for large areas of skin of the face and temple region are situated in the parotid gland. Tumors in the parotid gland can therefore represent spreading from primary tumors localized in the skin of the temple area and outer ear (7).
Lymphatic spreading at the time of diagnosis is uncommon.
Distant metastases are relatively rare, but in such cases, the lungs are the most common localization.
Adenoid cystic carcinoma, however, has an unusual metastatic pattern and metastasizes late.