Although pleomorphic adenomas of the salivary glands are benign tumors, they can metastasize to distant organs without evidence of malignant transformation. We describe FDG PET/CT finding in a case of metastasizing pleomorphic adenoma in the right ilium occurring 22 years after initial surgical resection of a lip pleomorphic adenoma. On FDG PET/CT, the iliac metastasis appeared as an expansile osteolytic lesion with heterogeneous activity. This case indicates that metastasizing pleomorphic adenoma, although rare, should be included in the differential diagnosis of FDG-avid osteolytic bone lesions in patients with a history of salivary gland pleomorphic adenoma.
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