Malignant oncocytomas are extremely rare tumours of the salivary glands. Fewer than 50 cases have been reported in the world literature so far, 34 of which were located in the parotid gland. Only three of these tumours have been located in the submandibular gland. We report one further case of a malignant oncocytoma of the submandibular gland in a 47-year-old man. Since a definite histological diagnosis of malignant oncocytoma can rarely be made both clinical and histopathological findings are essential in establishing the diagnosis. Treatment consists of wide surgical excision, neck dissection and post-operative radiotherapy. The prognosis with regard to five-year survival is poor becauseof metastatic disease.

Neurofibroma affecting the major salivary gland is uncommon. This tumour is particularly rare in the submandibular and sublingual gland.

Here, a case of solitary plexiform neurofibroma of the submandibular gland without any other manifestations of von Recklinghausen's disease is presented. It is probably the first case report of this tumour invading the submandibular gland in a solitary form.

The usefulness of fine-needle aspiration cytology (FNAC) in the diagnosis and treatment of submandibular gland lesions is not well known. The 210 FNACs taken from submandibular gland lesions at Turku University Central Hospital between 1984 and 1991 were reviewed. Of these FNACs, 78 samples from primary lesions were confirmed histologically. Within this subset 10 FNACs were taken from benign neoplasms, all of which were correctly classified (sensitivity 100 per cent; specificity 88 percent). Only four of the 14 FNACs from malignant lesions were cytologically considered malignant (sensitivity 29 per cent). On the other hand, four FNACs raised a false suspicion of malignancy (specificity 6 per cent). Out of 54 FNACs from non-neoplastic lesions 43 were correct (sensitivity 80 per cent; specificity 63 per cent). There were 104 patients (123 FNACs), who had not been operated on: the follow-up of these patients shows that in this subset of FNACs there were no false malignant but probably one false benign finding (1 per cent). We conclude that FNAC can offer valuable information about the type of the submandibular gland lesion, but the decision of operative and other treatment should not be based solely on the result of FNAC.

A rare case of adenocarcinoma of the submandibular gland with positive serum measurements and tissue immunohistochemical stainings for both CEA and CA 125 is presented.