A case is presented of a rare congenital anomaly of the fourth branchial arch, which presented as an abscess in the anterior triangle, related to a fistula communicating with the pyriform fossa. Histopathological examination showed the fistula to be associated with thyroid tissue supporting the hypothesis that the ventral wing of the fourth pouch contributes to the thyroid gland.

A case of a rare leiomyomatous hamartoma arising in the posterior tongue of a sixteen-month-old male is reported. There has been no recurrence following simple excision and presenting symptoms of choking on swallowing have resolved. Most other leiomyomatous hamartomas in the upper aerodigestive tract have been reported in Japanese patients and have involved the maxillary gingiva and hard palate.

Nasal tuberculosis represents a rare manifestation of infection by Mycohacteriurn tuberculosis: a case is presented together with a review of the literature. The correct management is documented, especially the need to treat the patient as if there was a generalized condition, and the problems concerning drug resistance are also considered. The incidence of this disease is rising and its importance must once again he highlighted.

Osteoma is the commonest benign tumour of the paranasal sinuses (Handousa, 1952). A case of a large osteoma removed from the frontal and ethmoid sinuses is presented. Histopathological examination of this tumour revealed evidence of bony remodelling similar to that seen in Pagets' disease which has not been previously reported. The pathological significance of this finding is discussed.

Cystic lymphangioma is a congenital lesion which rarely presents in adult life and even less commonly arises within salivary tissue. We report the sudden appearance of a large cystic lymphangioma within the parotid gland of a young man and discuss the management of this rare condition.

It is now a widely held belief that so-called ‘lateral aberrant thyroid’ tissue actually represents a metastasis from a malignant tumour of the thyroid gland. A case is presented which suggests that this is not always true, and an extensive review of the relevant literature is discussed.

We report a case in which a squamous cell carcinoma was found to have arisen from a delto-pectoral skin flap used in pharyngeal reconstruction. The flap had been forming a neo-pharynx for 24 years. No other signs of recurrent disease had developed in this period. This raises the possibility of tumour induction in heterotopic skin used for oropharyngeal reconstruction.

A case of basal cell adenocarcinoma of the parotid gland is reported. Histologically it is to be distinguished from basal cell adenoma and adenoid cystic carcinoma. Clinically the presentation may appear benign. Surgical excision is the treatment of choice. The prognosis is uncertain because of lack of follow-up data.

Fibrous histiocytoma is uncommon in the head and neck region and rare in the larynx. Its behaviour is unpredictable.

A case is reported in a 54-year-old male which was treated conservatively initially and which recurred several times over a seven year period. During that time the appearances of the lesion changed from those of a densely collagenous, cytologically benign tumour to those of a richly cellular and potentially malignant neoplasm. Laryngectomy was eventually undertaken.