Extracranial carotid artery aneurysms are rare, but are occasionally recognized as causing dysphagia. These aneurysms generally occur at or above the bifurcation. Here we present what we believe is a unique case: a common carotid artery aneurysm compressing the upper oesophagus, and mimicking the obstruction of a post-cricoid carcinoma.

Bilateral pneumothorax may occur after emergency tracheotomy, if a significant upper airway obstruction with a large negative intrathoracic pressure exists.

Fourth branchial pouch anomalies are rarely reported. A case is described of an isolated branchial cyst which was found to contain ectopic thyroid tissue. This case, together with four others previously reported, support the theory that the thyroid gland may receive contributions from the fourth branchial pouch during development.

Maxillary sinus shrinkage can occur secondary to acquired benign osteomeatal disease. This may be associated with an external deformity and sinus wall sclerosis.

True malignant mixed tumours (carcinosarcomas) of salivary gland origin are rare and not widely recognized lesions. These tumours account for approximately 0.2 per cent of all malignancies of the major salivary glands (Stephen et al., 1986). They usually occur in pre-existing pleomorphic ademonas of major salivary glands and have an aggressive and often rapidly fatal progression.

We report a case of carcinosarcoma in a minor salivary gland of the upper lip. Its management and the use of immunocy-tochemical stains to demonstrate the separate epithelial and connective issue components are discussed.

This case report describes the rare complication of an adenocarcinoma developing in a colonic interposition graft 20 years following surgical resection of a postcricoid squamous carcinoma. A free jejunal graft was used for further oesophageal reconstruction following resection of the colonic graft.