OBJECTIVE: Adenoid cystic carcinoma is relatively unusual, representing 10-15% of all major salivary gland neoplasms and approximately 12.3% of minor salivary gland cancers. The objective of this paper is to present a case of adenoid cystic carcinoma and to discuss the clinical and histological particularities that generate therapeutic controversies. Clinical Case: H.P., a 51-year- old man, presented with nasal obstruction on the right side associated with mild rhinitis symptoms and swelling in the right nostril evolving for months. Rhinoscopy showed swelling and degeneration in the right inferior turbinate with a mass on the right nasal wall. Computed tomography (CT) of the paranasal sinuses revealed a nodular lesion with soft tissue density involving the right nasal wall and causing posterior septal deviation to the right. The patient underwent an incisional biopsy of this lesion. Pathological examination showed a salivary gland tumor with an aspect of basal cell adenoma. The same material was sent for immunohistochemistry and a cystic adenoid carcinoma was diagnosed. The patient was referred to the head and neck surgery department, where he underwent a right anterior-medial maxillectomy, including resection of the inferior, middle, and upper turbinates extending to the ethmoid. CONCLUSION: Malignant sinonasal tumors are relatively unusual. The rarity of these lesions has hindered the accumulation of knowledge of major causes; most reports are observational and results of local oncologic control and survival remain unsatisfactory with current modes of treatment, including aggressive surgery.