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At high power some of the cohesive groups of epithelial cells may contain no hyaline material but form fingers or balls of cells with common cell borders at the periphery. The nuclei are round and oval with dark staining inconspicuous nucleoli. Since adenoid cystic carcinomas infrequently spread initially to regional lymph nodes, no lymph node dissection is required, at least intially. Nerves near the tumor, however, are usually generously excised with a possibility of performing a nerve graft of the facial nerve at a later operation. Radiotherapy is effective in most cases, and should be considered for recurrent tumors, inoperable masses or excisions with limited surgical margins.
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