Mycobacterial infection of the parotid gland: an unusual cause of parotid swelling.

Six cases of mycobacterial infection of the parotid gland are reviewed. All six cases presented solely with a slowly enlarging parotid swelling clinically indistinguishable from a parotid tumour. All of the swellings required surgical removal, superficial parotidectomy in four cases, and enucleation in two cases to obtain a definitive diagnosis.

Ceruminous gland tumours: a reappraisal.

Ceruminous glands should no longer be regarded as purely apocrine glands, but as apoeccrine glands with both apocrine and eccrine modes of secretion. We present two cases of pleomorphic adenoma of ceruminous glands, among the rarest of such tumours. The use of such terms as 'ceruminoma' and 'hidradenoma' should finally be abandoned, and 'ceruminous gland tumour' used instead as a generic term. Classification should be based on Wetli's prototype (adenoma, pleomorphic adenoma, adenoid cystic carcinoma and adenocarcinoma), with the addition of benign eccrine cylindroma and syringocystadenoma papilliferum; the inclusion of mucoepidermoid carcinoma should await full validation. Wide local excision is necessary for all tumours, with only follow-up for histologically benign neoplasms. Malignant tumours need early aggressive surgery and radiotherapy. If marginal invasion cannot be assessed histologically, then adenoma and adenocarcinoma cannot be distinguished and we suggest that the tumour be reported as 'of uncertain malignant potential'. Long-term studies are needed to confirm or refute the view that all ceruminous gland tumours are potentially malignant.

Terminal parotid duct carcinoma.

Terminal duct carcinoma of salivary glands is an uncommon, histologically distinctive, low grade malignant neoplasm arising from the intercalated salivary duct. We present a case arising eight years after removal of a parotid tumour reported as a pleomorphic adenoma. We describe the clinico-pathological features of the present tumour, illustrate the difficulties that may be encountered in differentiating it from other salivary gland tumours, and discuss the possible significance of the previous tumour.

Sarcoidosis: a cause for bilateral facial palsy.

The facial nerve is commonly involved in neural sarcoidosis, but there is only one reported case in which bilateral facial paralysis was the sole manifestation of sarcoidosis. We report a case of sarcoidosis presenting with bilateral facial paralysis as the only sign. The pathology, clinical presentation, pathophysiology and diagnosis of sarcoidosis has been discussed.

Paradoxical vocal cord motion: an unusual cause of stridor.

Stridor due to obstructive causes is relatively common. Functional airway obstruction with paradoxical vocal cord motion is uncommon. Only 12 cases have been reported in the literature in the past 15 years. The majority were young female patients. We have recently encountered two cases. Lack of awareness of this condition caused several problems in management.