FWposdObjective: To describe the clinical presentation, treatment techniques, outcome, and complications of a large single institutional experience with long-term follow-up after surgery and post-operative radiation therapy for the treatment of minor salivary gland malignancies.

Cicatricial pemphigoid is a chronic vesiculobullous disease of the mucosal epithelium that primarily involves the oral cavity and the eyes. The clinical and histologic features are identical to those of bullous pemphigoid, and these features often can be nonspecific for other disease processes. It is not unusual for a period of 1 year or more to elapse before a diagnosis is made. The diagnosis of cicatricial pemphigoid requires characteristic lesions and histopathologic evidence of immunoglobulin deposition along the basement membrane, as well as a high index of suspicion. The authors detail a case of cicatricial pemphigoid resulting in airway obstruction and present the treatment required for both stabilization of the airway and resolution of the disease process.

Presentation of CaseA 69-year-old woman was admitted to the hospital because of a right orbital mass with chronic conjunctivitis.One month before admission she had noticed that her right eye was bloodshot. An ophthalmologist found a mass beneath the lateral aspect of the right lower lid with overlying conjunctival injection. Dexamethasone eye drops were prescribed. A computed tomographic (CT) scan of the orbits (Figure 1 and Figure 2) showed a slightly ill-defined, enhanced mass in the inferior and lateral anterior right orbit, without calcification or cavitation; there was no bone destruction, paranasal sinus disease, or evidence of an intraocular malignant tumor. . . .

Chondroblastoma is a rare tumor of bone that represents approximately 1% of all primary bone tumors. In the temporal bone, only 33 have been reported. We present a case of chondroblastoma of the temporal bone, followed by a literature review and analysis of reported cases. We conclude that the best chance for a prolonged disease-free interval is total excision using a combined otolaryngologic and neurosurgical approach.

Presentation of CaseA 65-year-old man was admitted to the hospital because of a large mass that invaded the base of the right side of the skull.The patient was well until 18 months earlier, when he experienced painless horizontal diplopia. He consulted an ophthalmologist, who found right hypertropia. On a random determination the blood glucose level was reported to be normal. The diplopia resolved spontaneously after four days, and the patient failed to return for a planned visual-field examination. He then became lost to follow-up examination until nine months before entry, when painless horizontal diplopia recurred. He returned to . . .

Presentation of CaseA 13-year-old boy was admitted to the hospital because of chronic otitis media, episodic dizziness, fluctuating left-sided hearing loss, and a destructive process in the left mastoid bone.There was a long history of otitis media. The insertion of bilateral pressure-equalization tubes six years before entry was followed by improvement in the bouts of otitis media. Repeated audiometric examinations performed at school and in his pediatrician's office showed no evidence of hearing loss. Five years before admission the right pressure-equalization tube was extruded. One year before entry left-sided otorrhea occurred and was treated with topical antibiotic drops. . . .

Sinonasal hemangiopericytomas are rare, occasionally misdiagnosed neoplasms that have often been considered distinct from hemangiopericytomas of other sites. Eleven cases were studied. Nine arose from the nasal cavity and two from the paranasal sinuses. The patients' mean age was 58 years. In nine cases there were no appreciable mitoses; in two, mitoses were frequent. Of 10 cases studied by immunostaining, all were positive for vimentin; two had faint focal staining for actin; one focally expressed S-100 protein; all were negative for cytokeratins, desmin, and Factor VIII-related antigen; and none bound Ulex europaeus agglutinin 1. Five cases were studied by electron microscopy. The most consistent features were basal lamina-like material partly surrounding tumor cells and completely separating them from endothelium, tapered cytoplasmic extensions, and orderly bundles of filaments. Intercellular junctions and pinocytotic vesicles were present in some tumors. Of nine cases with adequate follow-up, tumors recurred in four cases (44%) after a mean of 6.5 years, and none metastasized. A review of the literature showed that high local recurrence rates, late recurrences, and low rates of metastasis were features of tumors in this location. This might be a reflection of early presentation, small tumor bulk, and difficulty of complete resection, rather than evidence for a biologically distinct neoplasm.

An unusual form of squamous cell carcinoma of the tongue is reported, the “de novo” submucosal evolution of which is unique. Histologic definition of this malignancy and its distinction from clinically similar benign and malignant conditions are detailed through a brief review of the relevant differential diagnoses. The importance of circumspect diagnostic reassessment when the clinical behavior of a lesion contradicts apparent histologic benignancy is emphasized and treatment inferences are drawn.

Heterotopic cervical salivary gland tissue was found in a 4-yr-old girl with branchial and otologic abnormalities. Her mother and sister also had heterotopic cervical salivary tissue in association with anomalies that suggest the branchio-otorenal (BOR) syndrome. Heterotopic cervical salivary gland tissue may result from abnormal branchial development.

Presentation of CaseA 41-year-old man was admitted to the hospital because of hypertension and dyspnea.He was well until 13 years earlier, while he was spending a year in France, when cough, sore throat, hoarseness, and fever developed. An injection of penicillin was followed by urticaria, and no further antibiotic treatment was prescribed. His other symptoms subsided, but the cough continued and was productive of purulent sputum. X-ray examination of the chest and a tuberculin skin test were reported to be negative. After six weeks his symptoms disappeared, but bilateral episcleritis developed and resolved after the topical administration of . . .