Intraoral adenoid cystic carcinoma. The presence of perineural spread in relation to site, size, local extension, and metastatic spread in 22 cases. Twenty-two patients with an intraoral adenoid cystic carcinoma (ACC), initially treated by surgery with or without postoperative radiotherapy, were examined for the presence of perineural spread in relation to primary site, size, local extension, histologic status of the surgical margins, and metastatic spread of the tumor. There seems to be no correlation between perineural spread and the primary site or size of the tumor. However, perineural spread occurred more often in tumors with local extension and in cases with surgical margins with positive results. There seems to be no statistically significant correlation between perineural invasion and distant metastatic disease. 