The authors present the case of a 73-year-old female patient with a five-year growing gigantic tumour of the submandibular gland. Due to its size the tumour caused respiratory complaints, difficult swallowing, restricted mobility of the tongue and paresis of the r. marginalis n. VII. Despite considerable medical risk (IHD, hypertension, diabetes mellitus) radical resection of the tumour - an adenoid cystic carcinoma - was performed.Thepostoperative condition ensured a better quality of life than during the preoperative period, although it was complicated by the development of a complete cervical fistula originating in the mesopharynx. Despite the favourable local finding, after six months pulmonary metastases were detected and the patient died ten months after operation. The authors discuss the problem of extensive tumours where the decision on the optimal procedure must be individual.

        Key words: gigantic tumour, adenoid cystic carcinoma, submandibular gland, surgical treatment.