OBJECTIVE A case of adenoid cystic carcinoma (ACC) of the Bartholin's gland in a 34-year-old woman with unusual presentation and early recurrence is reported. METHODS Clinical and histologie features were recorded. Immunohistochemical stains and cell-cycle analysis by flow cytometry technique on paraffin-embedded tumor tissue were performed. RESULTS The tumor presented as a painful nodule in the episiotomy scar three months after delivery. Initial treatment included only wide local excision. Six months later local recurrence occurred despite clear surgical margins. Histologically a predominant "classic" cribriform growth pattern was identified. Immunoreactivity in tumor cells supported dual epithelial-myoepithelial differentiation. Estrogen and progesterone receptors were negative. The DNA histogram revealed a diploid stemline and a low S-phase fraction. CONCLUSIONS ACC of the Bartholin's gland is a rare malignant tumor with great propensity for local recurrence. The optimal therapeutic approach has not been established due to the lack of well-defined prognostic parameters.