Primary intraosseous salivary gland
tumors are rare, with mucopidermoid
carcinoma being the most frequent histotype. The authors present a case of
adenoid cystic carcinoma, located in the mandibular incisor region, associated with
pain. Endodontic treatment resulted in increased
pain and progressive mandibular expansion. An
apicoectomy was conducted, and an intraosseous
adenoid cystic carcinoma was diagnosed at histological examination. The patient was treated by wide surgical resection, and is alive and well without recurrences or distant
metastases 14 yr after the original diagnosis. The case presented herein calls attention to the preoperative clinical diagnosis of periapical lesions. Radiologically, focal sclerosing
osteitis, cementoblastoma, cementifying and
ossifying fibroma, periapical cemental dysplasia, complex
odontoma, and
calcifying epithelial odontogenic tumor should be considered in the differential diagnosis. In addition the unusual occurrence of salivary gland
tumors in intraosseous location stresses the importance of systematic histological examination of any tissue sample obtained after endodontic procedures.