This 47-year-old woman consulted her dentist for evaluation of dull aching pain in the right upper molars. On examination a tumor was noted on the palate and she was referred to the Clinical Stomathology Service of the Faculty of Dentistry of the Venezuelan Central University. The patient was a smoker and was unaware of the tumor. After routine evaluation including teeth vitality tests (which where negative), an incisional biopsy procedure was performed. Histopathology confirmed the diagnosis of adenoid cystic carcinoma. This tumor is one of the more common salivary gland malignancies. Although it can arise in any salivary gland, 50% arise within the minor salivary glands, and the palate is the most common site. Adenoid cystic carcinoma appears is a slow growing tumor, and pain probably occurs because of the propesnity for perineural invasion. Tumors can be smooth topped or ulcerated and usually produce bony destruction. Surgical excision is the treatment of choice, local lymph node involvement is unusual, but late recurrences result in 80% mortality over 2 decades. The photomicrographs were taken by Professor Mariana Villarroel, PhD.
On medium magnification the cyst-like spaces are seen to contain a basophilic mucoid material.