A unique case of adenoid cystic carcinoma arising in a ceruminous gland, with widespread pulmonary metastases, is presented. This is the first case in the English literature in which the diagnosis was made from material obtained by needle aspiration from a pulmonary metastasis. The literature is reviewed and the histological features and clinical course are discussed in the paper. Adenoid cystic carcinoma is the most common tumor of ceruminous gland origin, and is the only one which produces widespread metastases in the lungs. Tumors arising from ceruminous glands are slightly more prevalent in females, and pulmonary metastases occur almost three times as often in females as in males. Suggested treatment is wide local excision of the primary tumor and of local recurrences, and excision of distant metastases when possible. Irradiation is useful only for palliation. All patients, but especially females, should be followed carefully for the detection of possible pulmonary metastases.