Purpose: Adenoid cystic carcinoma (ACC) is a malignant salivary gland tumor with a high mortality rate due to late, distant metastases. This study aimed at unraveling common genetic abnormalities associated with ACC. Additionally, chromosomal changes were correlated with patient characteristics and survival. Experimental Design: Microarray-based comparative genomic hybridization was done to a series of 18 paraffin-embedded primaryACCs using a genome-wide scanning BAC array. Results: A total of 238 aberrations were detected, representing more gains than losses (205 versus 33, respectively). Most frequent gains (>60%) were observed at 9q33. 3-q34.3, 11q13.3, 11q23.3, 19p13.3-p13.11, 19q12-q13.43, 21q22.3, and 22q13.33. These loci harbor numerous growth factor [fibroblast growth factor (FGF) and platelet-derived growth factor (PDGF)] and growth factors receptor (FGFR3 and PDGFRh) genes. Gains at the FGF(R) regions occurred significantly more frequently in the recurred/metastasized ACCs compared with indolent ACCs. Furthermore, patients with 17 or more chromosomal aberrations had a significantly less favorable outcome than patients with fewer chromosomal aberrations (log-rank = 5.2; P = 0.02). Conclusions: Frequent DNA copy number gains at loci of growth factors and their receptors suggest their involvement in ACC initiation and progression. Additionally, the presence of FGFR3 and PDGFRh in increased chromosomal regions suggests a possible role for autocrine stimulation in ACC tumorigenesis.Adenoid cystic carcinoma (ACC) is one of the most common malignant tumors of the salivary glands. The tumor consists of epithelial and myoepithelial cells and is characterized by slow growth, multiple late recurrences, and distant metastases, mostly to the lungs, bone, and liver (1). The neoplasm rarely metastasizes to lymph nodes, preferring the hematogenous route. Furthermore, ACC shows pronounced infiltration, often with perineural spread.Three different histologic subtypes have been described: the cribriform type (1), exhibiting monomorphic cell islands with punched-out spaces, causing the ''Swiss cheese pattern''; the tubular type (2), composed of ductal structures lined by two or more cell layers within a fibrous stroma; and the solid type (3), which is composed of basaloid tumor cells and can contain foci of necrosis, cellular polymorphism, and mitoses. However, in most ACCs, two or more patterns are recognized.With respect to chromosomal alterations in ACC, fluorescence in situ hybridization and loss of heterozygosity (LOH) analysis studies (2 -7) have shown frequent 6q and 17p deletions and a recurrent t(6;9)(q21-q25;p21-p22) translocation. Immunohistochemistry has implied various proteins as molecular markers of progression in ACC, but results were inconclusive (8 -12). Only p53 proved to be a consistent marker of aggressiveness in ACC, being highly expressed in the solid pattern (13), correlating with unfavorable clinical outcome (14) and having high LOH rates (15). Recent oligonucleotide microarray analyses ...