The adenoid cystic carcinoma is the most common tumour among minor salivary glands, and accounts for about 30% of all malignant salivary gland tumours. About 70% arise in the oral cavity. It is uncommon in the parotid.
The tumour has a characteristic cribriform, i.e. sieve-like, microscopic appearance caused by numerous small spaces in a tightly-packed tumour cell mass. There is a great propensity for neural spread causing neuropathy and pain disproportionate to the size of the lesion.
It is highly invasive with early regional and systemic metastasis; the instance of metastases is up to 50% and increases with time. Treatment is by primary radical surgery which usually destroys the facial nerve.
Radiotherapy offers little benefit. Patients have a protracted illness. Recurrence is common and may occur as long as 15 years after apparently successful eradication. Those with distant metastases may survive for 5 or more years.
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