Five adult patients with vascular malformations in the parotid region are described. Three of these patients had lumps in the parotid gland clinically indistinguishable from parotid tumours: one had a diffuse swelling of the check, and the fifth had a pulsatile tumour in the deep lobe of the gland. Two patients had a characteristic sign-the lump in the cheek became more obvious, both visually and on palpation, when the masseter muscle was tensed. In 3 of the patients calcified opacities, resembling phleboliths, were demonstrated on plain X-ray examination. This is only the third report of vascular malformations of the parotid region in the British literature; no other report of a pulsating tumour within the parotid gland has been found in a search of the world literature.

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Case reportA 32-year old man complained of a painless swelling in the left groin, of 4 months duration. Examination showed a non-tender, irreducible mass in the left inguinal region. The external genitalia were normal. A diagnosis of incarcerated inguinal hernia was made, and the patient was therefore admitted for early operation.Via an inguinal incision, the spermatic cord was easily mobilised from the presumptive direct inguinal hernia. It became clear, however, that the 'hernial sac' was in fact a thin-walled cyst, 8.5 x 6 ern, containing pultaceous material. The cyst protruded beneath the conjoint tendon, and had originally extended to the superficial inguinal ring (Fig 1). HistologyThe cyst wall was composed of squamous epithelium, with hair follicles, sebaceous glands, and apocrine sweat glands (Fig 2, apocrine glands at top right).These findings are characteristic of a sequestration dermoid, formed when ectodermal fu-