Adenoid cystic carcinoma (ACC) is a malignant tumor originating from head and neck glands, accounting for 10 %–15 % of all salivary gland tumors [1–3], with pulmonary metastasis rates ranging from 20 %–40 % [4–6]. Early prediction of pulmonary metastasis is critical for prognostic evaluation and personalized therapeutic planning. In advanced cases, surgical resection of metastases is rarely indicated, with systemic therapies (chemotherapy, targeted therapy, or immunotherapy) predominating to con…