When salivary gland enlargement occurs in association with other ENT symptoms, Wegener's granulomatosis should be considered in the differential diagnosis. An early anti-neutrophil cytoplasmic antibody (ANCA) test may aid diagnosis. Effective medical treatment exists and, once the diagnosis has been made, therapeutic excision of the affected gland may be unnecessary. The fourth and fifth cases in the literature of salivary gland involvement in Wegener's granulomatosis are reported.

Angiosarcomas are extremely rare in the head and neck and the histological diagnosis is often difficult. We present a case of a haemangiosarcoma of the maxillary antrum in a 33 year old male. The histological diagnosis and subsequent management are discussed.

Permanent blindness, is a very rare, but devastating complication of simultaneous bilateral neck dissection. Most otolaryngologists/head and neck surgeons are unaware that amaurosis can result from this surgery, and this paper is meant as a poignant reminder of that end. A case report is presented, followed by a discussion of possible aetiology; a management protocol is proposed.

Carcinoma ex-pleomorphic adenoma is an uncommon tumour of the parotid gland. True malignant mixed tumours of the parotid are rare and we could find only 14 such cases reported. A case of a 76-year-old man diagnosed as suffering from this entity is presented. The diagnosis was based on a series of immunohistochemical studies demonstrating the existence of two separate sarcomatous and carcinomatous elements. The clinical and histological data are presented and the literature is reviewed.

Nasopharyngeal carcinoma continues to be a difficult diagnostic problem in many patients. It is well known that amongst the many and varied manifestations of this disease, a unilateral middle ear effusion in an adult should be regarded with suspicion. Such a case in a 42-year-old patient is presented. In this case the benefit of Gadolinium enhanced magnetic resonance imaging over and above computerized tomography is demonstrated.

A case of papillary adenocarcinoma of the middle ear is presented. The patient had an unusually short history of otalgia, aural discharge and facial palsy, and, at presentation the tumour was too large for surgical resection to be a feasible option. The managementof this rare tumour is discussed and the relevant literature reviewed.

Haemangiopericytoma is an uncommon vascular tumour with a widespread distribution. Although meningeal involvement is well recognized, only a few sporadic cases of temporal bone lesions have been documented, all with doubtful sites of origin. Late presentation together with the restrictive anatomy of this region often precludes its effective removal and even minimal residual disease may progress rapidly. A series of three such patients are presented in order to discuss the natural history, histological features and treatment of this disease.

Cavernous haemangiomata occur quite commonly, but one situated in the hypopharynx which contains as many as 240 phleboliths, as reported here, is a rare curiosity. The clinical manifestations, angiographic findings and the operative procedure of this case are described with a brief review of the formation of phleboliths in cavernous haemangiomas.