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Adenoid cystic carcinoma is a rare, slow-growing neoplasm. It is most commonly located in the salivary glands, affects people older than 55 years of age, and has a predilection for women. These lesions may recur locally but have shown low metastatic potential. We present the unique case of a 71-year-old female with a nonraised hyperpigmented lesion isolated to the right heel. Confusion surrounded the clinical presentation of this dermatologic lesion, and many physicians postulated several differential diagnoses. The purpose of this case report is to bring further awareness to this rare dermatologic variant of adenoid cystic carcinoma, which has been rarely reported in the literature.