Parapharyngeal [corrected] salivary duct carcinoma involving the cavernous sinus.

Salivary duct carcinoma (SDC) is a relatively uncommon malignant tumor of the salivary gland derived from the excretory duct reserve cells of the salivary glands. The authors report a case of SDC in a 34-year-old man who presented with trismus and left sided headache, radiologically by a left parapharyngeal mass involving into the left cavernous sinus and histologically by intraductal growth pattern with a cribriform appearance and comedonecrosis. Perineural invasion of the mandibular branch of trigeminal nerve is demonstrated. Clinical and pathologic features with relevant literatures are reviewed.

Fatal fulminant hepatitis associated with Ganoderma lucidum (Lingzhi) mushroom powder.

Hepatotoxic effect related to Ganoderma lucidum (Lingzhi) mushroom powder was first described in a patient from Hong Kong in 2004. In 2005, the authors experienced a case of fatal fulminant hepatitis associated with such a preparation. Both patients had taken other therapeutic agents and traditionally boiled Lingzhi without any toxic effect. After switching to taking Lingzhi in powder form for 1-2 months, the hepatotoxic episode occurred in both patients. The toxic role of Lingzhi powder needs close monitoring in the future, especially in combination with other drugs.