A case of progressive hemifacial atrophy (PHA) with extensive atrophy of the walls of the maxillary sinus is reported. Prolapse of subcutaneous tissue and orbital fat through the bony defect simulated the presence of a tumour and led to surgical exploration. Such a severe degree of bony involvement with relatively mild soft tissue atrophy is exceptional. Radiological evaluation by hypocycloidal tomography contributed greatly to the diagnosis in this case.

Unilateral progressive atrophy of the face was first described by Parry (1825) and by Romberg (1846). Eulenberg (1871) coined the name ‘progressive facial hemiatrophy’, but ‘progressive hemifacial atrophy’ (PHA) is a more appropriate term (Gorlin and Pindborg, 1964; Kabir and Halprin, 1964). The disease commences usually in the first or second decade of life, and is more common in females. Over several years there is a slowly progressive atrophy of the face on one side, with involvement of the skin and subcutaneous fat, and on rare occasions also of the muscles and bones (Gorlin and Pindborg, 1964; Finesilver and Rosow, 1938; Bramley and Forbes, 1960; Singh and Bajpai, 1969; Crikelair et al., 1962). The etiology of the disease is unknown.

We report an unusual case in which the hemifacial atrophy affected the bone much more than the soft tissues and which presented as a mass in the maxillary sinus.

The light microscopic and ultrastructural features of a laryngeal salivary duct carcinoma are presented. By light microscopy, the neoplasm bore a marked resemblance to the infiltrating duct carcinoma of the breast. Ultrastructurally, the tumour was characterized by the presence of two principal types of cells, i.e. epithelial and myoepithelial cells, arranged in duct-formation.