Abstract
BACKGROUND: Adenoid cystic carcinoma is a salivary gland cancer that grows slowly and has an unfavorable prognosis. The occurrence of adenoid cystic carcinoma in the parotid gland is extremely uncommon. It presents in three histopathological patterns: cribriform, tubular, and solid, and it is classified into three grades: grade i, grade ii, and grade III. CASE PRESENTATION: We report the case of a 27-year-old female patient from the Ankole tribe, Bantu ethnicity, who had a long-existing, painless lump in her submandibular area and later developed worsening weakness in her lower limbs and back pain. Despite being present for 8 years, the mass was initially attributed to conventional health issues. Diagnostic tests revealed a metastatic adenoid cystic carcinoma of the parotid gland with significant involvement of the spine, which resulted in paraplegia. CONCLUSION: This case underscores the insidious nature of adenoid cystic carcinoma, stressing the necessity of early detection and the risks of delayed diagnosis influenced by cultural beliefs and restricted healthcare access. It also highlights the significance of following various steps in the diagnostic process.