Delayed metastases occur in 25–50% of patients with adenoid cystic carcinoma (ACC). Pulmonary metastasectomy as a curative procedure in ACC should be further investigated. ACC has a tendency to local recurrence and long-term distant metastases. Lung resection for metastatic ACC is acceptable if complete resection is feasible. Symptomatic benefits of incomplete lung resection in ACC remain to be proven.