Different patterns of malignant change may occur in pleomorphic adenoma; carcinoma ex-pleomorphic adenoma is one such malignant entity.Although in most instances, the features of malignant transformation are evident, some very well-differentiated cancers such as myoepithelial carcinoma or cancers that exhibit morphologically limited nuclear atypia may be somewhat challenging to diagnose. A 45 year old man presents to us with a recurrent swelling over the upper lip for ten years. It had been excised twice during this period; the histopathology being consistent with pleomorphic adenoma. This time, however, there was a co-existent ipsilateral submandibular swelling. He underwent wide local excision of upper lip swelling with primary reconstruction of lip defect and supraomohyoid neck dissection.Diagnosis of myoepithelial carcinoma could only be made by histopathological examination of the resected specimen. Myoepithelial differentiation of tumor cells was established by showing positivity for CK7 and SMA. To the best of our knowledge, this is the first case of myoepithelial carcinoma arising in a recurrent pleomorphic adenoma in the upper lip.

Calcifying Cystic Odontogenic Tumor (CCOT) constitutes 1% of all jaw cysts and considered as one of the rarest odontogenic lesions. It's a group of odontogenic entities which exhibits variety of clinical and biological behaviors. Even after many classifications and sub classifications COC remains a tough nut to crack for clinicians and pathologists. According to recent WHO classification of 2005 it has been reclassified as a tumor due to its diverse nature. Ameloblastomatous Proliferating type is very rare variant of CCOT which is not widely described in literature. This Clinicopathological conference presents one such case in young female patient and also discuss in detail about the differential diagnosis and management of such cases.

Aim: To find the role of PET-CT scan in management of locally advanced head & neck cancers. Materials & Methods: A prospective study was performed in 21 patients suffering from locally advanced head & neck cancers reporting to our centre from January 2014 to December 2015. All the patients who had T3- T4 lesions with metastatic lymph node disease were included in the study. They underwent PET-CT scan and the results were tabulated to check whether there was distant metastasis thereby altering the clinical staging of the disease. Results: Out of 21 patients, who under PET-CT scan, 9(42.8%) patients had distant metastasis to various organs. 8(38%) patients had more than one metastatic lymph nodes and 4(19%) patients had locally advanced disease with only one metastatic lymph nodal involvement. Conclusion: Though incidence of distant metastasis is less than 10 % in head and neck cancers, sometimes the clinician fail to identify the distant metastasis due to non-availability of PET-CT scan equipment or due its financial cost when the patient is not affordable. But appropirate steps must be taken based on the clinical symptoms of the patients which must not be ignore by the surgeon and PET-CT scan needs to be done which can change the whole treatment management of the patient.

Salivary duct carcinoma (SDC) is a rare and high-grade malignant tumor that arises predominantly in a major salivary gland and bears a striking histological resemblance to high grade ductal adenocarcinoma of breast. The sarcomatoid SDC is a rare subtype that comprises of both epithelial and sarcomatoid components. The authors describe a case of sarcomatoid SDC of parotid gland. Its histological features have been discussed. The patient was treated by total parotidectomy with wide local excision of the involved skin and ipsilateral neck dissection followed by adjuvant radiotherapy.

Background: The purpose of this study was to compare the efficacy of bupivacaine and lignocaine for the surgical removal of mandibular impacted third molars. The study focused on pain experience and analgesic consumption. Materials and Methods: Forty patients, aged between 18-45yrs, were selected each with bilateral mandibular third molar indicated for extraction under local anesthesia. The mean age of the patients was 24 years and the ratio of males to females was 23 to 17. All patients randomly received lignocaine 2% with adrenaline 1:200,000 for one extraction and bupivacaine 0.5% with adrenaline 1:200,000 for the other sided extraction. Results: The visual analog and global pain scores for both groups were outlined. There was no significant difference between bupivacaine and lidocaine for intra-operative pain experience. Conclusion: There were no signs or symptoms of central nervous system or cardiovascular system toxicity in this study and the routine use of bupivacaine in oral surgery would appear to be a safe and effective method of producing adequate surgical analgesia and an increased post-operative pain free period.

AIM: To find the prevelance and Incidence of head and neck cancer cases of other total body malignancies in our cancer centre. MATERIALS & METHODS: This is a retrospective analysis which was done in curie Manavata Cancer Centre in northern Maharashtra from 14th May 2007 to 30th November 2014. Total cases operated were 14368 out of which 2017 were head and neck cancers. RESULTS: Incidence of Head & Neck cancer cases in our 7 years study was around 14.03% of other total body malignancies. Males are more affected by Head & Neck cancer for around 82.01% than females contributing which is around 17.9%. Oral cavity malignancies contribute around 76.6% out of all head & neck cancer cases. Tongue cancers are more commonly affected which is around 33.4% followed by Buccal mucosa which is 29.77%. The mortality rate is high in buccal mucosa (32.35%) followed by tongue (27.4%). CONCLUSION: This retrospective study hopes to quantify and analyze the spectrum of Head and neck cancer out of the other total body malignancies. A tremendous effort is needed to identify such high prevelance, generate awareness and establish treatment modalities to meet this challenging statistical analysis.