Metastasizing mixed tumors (MMT) of salivary glands are inexplicably metastasize maintaining benign histology. There is no pathologic and flow cytometric analysis criteria to predict the metastasis. MMT is known to metastasize by local implantation, vascular and lymphatic embolization after multiple surgery to local recurrences of primary tumor. However, multiple metastasis including cranium and spine occurred even without surgery to the primary tumor in this case. No pathological evidence of malignancy could be found in both primary and metastatic tumor. MMT is considered as an low grade malignancy based on clinical behavior rather than histologic evidence, such as low mortality rate, long delay of metastasis after primary lesion. Cranial metastasis is also extremely rare and only two cases have been reported. We report this unusual case with a literature review.

We experienced a case of traumatic carotid cavernous fistula (CCF) which was occluded spontaneously within 7 days after transfemoral carotid angiography with complete disapperance of symtoms. Traumatic CCF is almost always type A and known to rarely resolves spontaneously. The suggested mechanism of spontaneous occlusion were manual compression of carotid artery, hypotension during percutaneous or open direct carotid angiography under general anesthesia in the past as well as thrombogenicity of iodinated contrast media and catheterization procedure itself are more related with recent transfemoral carotid angiography. The pseudoaneurysm managed with coil or balloon should be frequently followed up due to compaction by the surrounding thrombus.