Branchial cleft cysts typically present as a unilateral, fluctuant soft tissue swelling that are mostly localised deep to the anterior border of sternocleidomastoid in the lateral aspect of the neck at the junction of its upper third and lower two third. Diagnosis is usually straightforward and can be made clinically however FNAC facilitates diagnosis.Unusually they can mimic as an abscess or metastatic node and less commonly present at an unusual location. We encountered 3 cases where patients presented with neck swelling either with unusual presentation or atypical location or inconclusive FNA. This report describes a series of patients in which the diagnosis of branchial cysts was not straightforward and posed a diagnostic challenge.

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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.

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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.

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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.

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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.

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