Schwannoma of the hypoglossal nerve is an uncommon benign neoplasm. We present a 49-year-old female patient with hypoglossal schwannoma presenting as a painless mass in the SUBMANDIBULAR area.

Introduction: Basal cell adenoma (BCA) is a rare benign epithelial tumour of the salivary gland majorly involving the parotid gland, and rarely the SUBMANDIBULAR gland. Case Report: We describe a rare case of BCA of the SUBMANDIBULAR gland diagnosed preoperatively using fine needle aspiration cytology in a 60-year-old woman presenting with painless SUBMANDIBULAR swelling. The surgery went uneventfully, and the histopathological examination confirmed the diagnosis. Conclusions: BCA can be accurately diagnosed only through histological observations due to its resemblance to various benign and malignant salivary and non-salivary gland tumours, which are difficult to biopsy.

Introduction: Mammary Analogue Secretory Carcinoma of salivary glands (MASC) is a low-grade carcinoma of salivary glands of the head-neck region. It bears histological resemblance to Secretory Carcinoma of the breast and Acinic Cell Carcinoma (ACC) of the parotid gland. Its clinical behaviour and aggressiveness vary amongst individuals and experience in MASC of the SUBMANDIBULAR gland are limited. Case Report: We report a 16-year-old female with binary neck swelling in the SUBMANDIBULAR region. The hard swelling in the SUBMANDIBULAR region was a MASC and the soft cystic mass was a synchronous congenital lymphatic cyst in the neck. We report two unusual features, an extremely rare involvement of MASC of SUBMANDIBULAR salivary gland and the presence of a congenital lymphatic cyst in the area adjacent to the main tumour mass. Treatment was done by surgical excision of both the neck masses intoto and ipsilateral selective neck dissection (Level I-IV). Conclusions: While MASC's histological pattern has been described in previous studies, its clinical picture is rarely documented. This report aims to shed light on the clinical presentation of this under-diagnosed entity and the aggressive management protocol required during preoperative workup, intraoperative disease clearance and post-operative follow up of such patients. MASC of the SUBMANDIBULAR salivary gland is an uncommon cause of neck swelling in the adolescent age group, but due to its occasional aggressive nature, should be borne in mind as a possible differential diagnosis of salivary gland tumours.

Introduction: SUBMANDIBULAR region is surgically significant in the head and neck field and a mass in this region may have multiple differential diagnoses. Case Report: An elderly man came with a single 4×2. 5 cm swelling in the neck on the right side, just below the lower jaw, since one month. Ultrasound showed an irregular heterogeneous hypoechoic lesion in the right SUBMANDIBULAR space measuring 37×23 mm with mild internal vascularity. The SUBMANDIBULAR gland appeared separate but compressed. Fine needle aspiration was suggestive of spindle cell neoplasm. The swelling was excised under general anesthesia. By histopathological examination, the lesion was diagnosed as anaplastic lymphoma kinase-negative inflammatory myofibroblastic tumor (IMT) based on focal immunoreactivity with cyclin D1. The patient then received radiotherapy 60 Gray divided into 30 fractions over 6 weeks. The case had no evidence of recurrence or residual disease six months post-surgery. Conclusion: Tumefactive spindle-cell lesion in the head and neck can comprise inflammatory conditions, benign and malignant neoplasms or borderline neoplasms, such as nodular fasciitis and IMT. The definitive histologic diagnosis of IMT helps in tailoring the treatment modality based on its locally aggressive biologic potential.

ABSTRACT: INTRODUCTION: Salivary gland synovial sarcomas, constituting <1% of oral tumors, occurring mostly in young and adolescents age group, present diagnostic challenges. it clinically presents as a painless mass, often growing silently for months or even years. Grossly, synovial sarcoma presents as a tan or grey mass with multi-nodular or multi-cystic formations and is characterized by the presence of spindle cells and CKAE1/AE3, TLE-1, and CD99 positivity. Prognosis is influenced by patient demographics, tumor characteristics, and treatment modalities. Factors such as age over 35 at diagnosis, epithelioid type, and localization outside the head and neck region are associated with worse prognoses.CASE SUMMARY: We present a 48-year-old male with a swelling in the left SUBMANDIBULAR area with no other associated symptoms. An ultrasound of the lump showed a well-circumscribed, cystic cum solid mass, with internal vascularity. Fine needle aspiration cytology (FNAC) demonstrated nuclear pleomorphism and high mitotic activity. Excisional histopathology was done and diagnosis of unifocal synovial sarcoma was made, characterized by spindle cells, with a mitotic rate of 23 per 10 high-power fields, with positivity for CKAE1/AE3, TLE-1, and CD99 and negativity for S100 in tumor cells.CONCLUSION: We here presents a case of synovial sarcoma in an adult patient, with an unlikely site of occurrence This report also contributes to limited literature regarding this rare malignancy, shedding light on their clinical and diagnostic characteristics, and emphasizing identification of specific immunohistochemical markers such as CKAE1/AE3, TLE-1, and CD99 add to the understanding of its molecular characteristicsKEY-WORDS: Synovial sarcomas, SUBMANDIBULAR gland, spindle cells, immunohistochemical markers.

Chronic sialadenitis is a disease of salivary glands associated with chronic infections, systemic diseases and silolithiasis pathogenesis of the disease. Primary tuberculous submandibulitis is not a reported disease. The diagnosis was confirmed when a 45 years old lady suspicious to SUBMANDIBULAR gland tumor was operated on for excisional biopsy. Histological examination of the specimen by expert pathologist ruled out malignancy, granuloma or caseous necrosis. Cultures of discharge and tissue were negative for mycobacterium tuberculosis. The only positive diagnostic modality was Polymerase Chain Reaction for mycobacterium tuberculosis. Therefore, the four drug anti-TB regimen was initiated. After that a surgical fistula was healed and the patient left the hospital on her foot and there was no recurrence at least for one year. The endemic condition of tuberculosis in some populations has increased the rate of extra-pulmonary tuberculosis. One of the extra pulmonary sites may be the SUBMANDIBULAR gland.It is recommended to consider tuberculosis in the differential diagnosis of SUBMANDIBULAR gland masses especially in populations with endemic tuberculosis.

Introduction: Chronic sclerosing sialadenitis is a relatively uncommon disorder of the salivary gland. Because of its clinical similarity to a salivary gland neoplasm, this condition has been known as Kuttner tumor and is classified as a tumorlike lesion. Case Report: This is the first reported case of bilateral Kuttner tumor of the SUBMANDIBULAR glands in Iran. It was initially diagnosed as a primary SUBMANDIBULAR gland neoplasm whereas histological findings showed chronic sialadenitis. Excision of such masses is the treatment of choice.

Introduction: Haemangioma or hemangioendothelioma is amongst the commonest developmental, vascular lesions of infancy and childhood. Hemangioendothelioma of the salivary glands, however, is extremely rare. Due to their rarity, they may be misdiagnosed as lymphangiomas or other cystic lesions found more commonly in the region. This may lead to surgical complications including torrential hemorrhage that may have dire consequences for the patient. Case Report: Herein we present the case of a nine-year-old male with a cavernous haemangioma involving the left SUBMANDIBULAR gland which was diagnosed on-table due to inconclusive pre-operative radiological and pathological diagnosis. Fortunately, due to meticulous dissection and care the lesion was excised in toto without any significant blood loss. Conclusions: Haemangioma of the SUBMANDIBULAR gland is so uncommon that often it isn't even considered a differential diagnosis for cystic swellings and lesions in this region. Mistaken diagnoses preoperatively may prove disastrous for the patient. Excision of haemangiomas requires planning for hemostasis and blood loss if it occurs. Even minor iatrogenic manipulation of vascular lesions may completely obscure the field due to bleeding, making dissection and recognition of anatomical landmarks very difficult. This is especially dangerous in the SUBMANDIBULAR region due to the proximity of various vital vascular and neural elements. A differential of haemangioma should therefore always be considered by surgeons and radiologists alike for lesions with suspicious or indeterminate features, in this region.