Objective: To report an unusual case of spinal metastasis following surgical resection and adjuvant radiotherapy for primary acinic cell carcinoma of the parotid gland.

Case Report: A 42-year-old gentleman was referred to our institution with a left parotid mass. Total parotidectomy and selective neck dissection was performed, confirming a diagnosis of acinic cell carcinoma. Recommendation following histological margin review was for adjuvant radiotherapy. Four months following completion of treatment the patient presented with lower limb neurological deficit. Magnetic resonance imaging identified multifocal spinal deposits within the thoracic and cervical vertebrae. Subsequent unresectable local and regional recurrence was detected on routine review.

Conclusion: We describe an interesting case of parotid actinic cell carcinoma metastasising to the thoracic spine, presenting with acute spinal cord compression. Treatment modalities, outcomes and prevalence of metastatic disease are discussed.

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