Abstract: Objective: To investigate the CT imaging features of intraosseous adenoid cystic carcinoma (intraosseous adenoid cystic carcinoma, IACC) occurring in the jaw and analyze their clinical correlation. Methods: Patients with IACC who met the inclusion criteria between January 2015 and April 2025 were enrolled. A retrospective analysis was conducted on their clinical and CT imaging features. Results: A total of 10 IACC patients were included in this study, with a mean age of 48 years and a male-to-female ratio of 6∶4. The most common site was the posterior maxilla (50%, 5/10), and 60% (6/10) exhibited early neurological symptoms. The imaging findings were classified into mass-type (50%, 5/10) and cyst-like type (50%, 5/10). Mass-type IACC presented as solid soft tissue masses with irregular bone destruction, while cyst-like IACC showed cystic-solid soft tissue masses accompanied by expansile bone thinning and relatively smooth margins. Notably, 80% (4/5) of the cyst-like cases exhibited punctate or fibrous striated high-density shadows within the lesions, which may aid in differentiating them from other locally aggressive odontogenic cystic lesions of the jaw. Conclusion: Intraosseous adenoid cystic carcinoma is rare and easily confused with other jaw tumors. A summary of its clinical and radiological characteristics may improve diagnostic and therapeutic decisions.

Key words: jaw, adenoid cystic carcinoma, imaging characteristics, clinical manifestations