Pleomorphic adenoma is the commonest benign tumour of the major salivary glands. It can also occur in minor salivary glands, mainly in the oral cavity, but also in other sites in the head and neck both within and outwith the upper aerodigestive tract. We present a rare case of pleomorphic adenoma of the nasal septum with consideration of the clinical management and a review of the literature.

We report a hitherto undescribed case of co-existence of a pleomorphic adenoma and a tubular basal cell adenoma affecting the superficial lobe of the left parotid gland of a 53-year-old man. The histology of the pleomorphic adenoma is also of interest in that the prominent adipose metaplasia of its myxoid stroma yielded an appearance reminiscent of myxoid lipoma. The tubular basal cell adenoma showed gross cystic change, and its solid portion consisted of closely packed tubules lined by double layers of cuboidal cells with little intervening stroma. Unlike Warthin's tumour and membranous basal cell adenoma, both pleomorphic and tubular basal cell adenomas exhibit no propensity towards multicentricity or bilaterality. We, therefore, believe that their co-existence in the superficial lobe of the parotid gland of our patient is a mere concidence rather than association.

The case of a 75-year-old lady with a large parapharyngeal pleomorphic adenoma excised via a transpalatal peroral technique is presented. This is a new approach to the parapharyngeal space not previously described. A laterally placed full thickness soft palate split from the superior pole of the tonsil to 1 cm proximal to the pterygoid hamulus provided good surgical access to the whole length of the parapharyngeal space and allowed complete tumour excision with minimal morbidity.

Pleomorphic adenoma is the most common tumour to arise in the parotid gland. Diagnosis becomes difficult when such a tumour undergoes degeneration and presents with unusual findings. This can lead to erroneous decisions concerning treatment. We present two patients with pleomorphic adenoma of the parotid gland with cystic degeneration, describe the pathological findings and discuss some pitfalls in diagnosis and treatment. Both patients recovered uneventfully after surgery.