Adenoid cystic carcinoma is a rare tumour accounting for less than 1% of all head and neck malignancies and 10% of all salivary gland neoplasms. 50% of cases have been found in minor salivary glands but are also reported in nose, sinuses, upper airway, lacrimal glands and breast. Those affected are in the age group 20-84 years (mean 52 years). Adenoid cystic carcinoma of the head and neck is relatively rare and is characterized by slow evolution, multiple recurrences, protracted clinical course, and late distant metastasis but frequently metastasizes to lung. Here, we are presenting a rare case of adenoid cystic carcinoma metastasizing to kidney and masquerading clinically and radiologically as primary renal cell carcinoma. Lymph node metastases are unusual, hematogenous spread, often to the lungs is quite characteristic, metastasis to kidney being extremely rare.

Background: Prothrombin Time is a measure of the integrity of extrinsic and final common pathways of the coagulation cascade while aPTT is a measure of the integrity of intrinsic and final common pathways of the coagulation cascade.Our study has demonstrated the effect of liver disease on both Prothrombin Time (PT) and activated Partial Thromboplastin Time (aPTT), and the risk of bleeding in these patients on the basis of these parameters. Aims: To correlate the effect of liver disease on PT&aPTT and to evaluate the risk of bleeding in these patients on the basis of these parameters. Methods: Blood samples of patients with preliminary diagnosis of liver disease were collected in 3.2% sodium citrate (9 parts blood and 1 part sodium citrate). PT was measured using thromboplastin reagent and aPTT was measured using cephaloplastin reagent. Results: Coagulation parameters PT and aPTT are prolonged and platelet counts are decreased more frequently in cases of cirrhosis (chronic liver disease) and less frequently in cases of hepatitis and other liver diseases. Patients of cirrhosis who had prolongation of PT, aPTT or decreased PC had more chances of gastrointestinal bleeding as compared to those who had normal values of these parameters. Conclusion: Coagulation parameters PT and aPTT can be used to predict the amount of damage to synthetic capacity of liver in liver diseases, also to predict the risk of bleeding in case of chronic liver diseases.