Adenoid squamous cell carcinoma (ASCC) is a one of the histological variants of oral squamous cell carcinoma with a rare occurrence of less than 4% of all the cases. The tumour has a slight male predilection with lower lip being the most affected site. ASCC is said to have a varied biologic behaviour which accounts for its ability to metastasize to distant sites and hence has poor prognosis. The histopathology shows numerous duct-like structures with central acantholytic cells. Distinct cytological atypia is seen which aids in diagnosis of SCC. Special stains help in differentiating the tumour from other variants of SCC. The presented case of a 70-year-old female emphasizes the importance of histopathogical examination of the unusual and rarely observed ASCC which can be missed due to similarities with other entities. Recurrence rates being very high, proper treatment starting with definitive diagnosis is imperative.

Granulomatosis with polyangiitis (GPA) is a rare multisystem disease characterized by a triad of necrotizing granulomas affecting the upper and lower respiratory tract, vasculitis and glomerulonephritis. Oral lesions are seen in 6–13% of cases, although not life threatening but might be the first symptoms reported by the patient. Here we present a case of gingival growth, later diagnosed as GPA owing to the timely recognition by the dentist. A 33-year-old female reported for evaluation of soft tissue growth in her lower left back tooth region present for past 3 months. She had no relevant medical or family history. Clinically it looked like a benign hypertrophic gingival enlargement. The histopathological picture was suggestive of vasculitis and nonspecific granuloma formation. On further examination altered Renal Function Test and cavitating granulomas were noted in her lungs along with a positive cytoplasmic ANCA (c-ANCA) test which led to the diagnosis of GPA.