Brown's tumor, also referred as osteitis fibrosa cystica is a rare nonneoplastic diagnostically challenging consequence of hyperparathyroidism (HPT) which occurs due to increased parathormone secretions in blood, causing excessive calcium resorption from kidneys, bone resorption, and phosphaturia. Brown's tumor is a misnomer, presenting as cystic expansile lesions in bone, often misdiagnosed as neoplastic lesion or granuloma or abscess in bones. It can affect long bones, clavicle, ribs, and pelvis. According to literature, skeletal manifestations of Brown tumor is relatively rare and occurs in <2% of the cases of HPT. We present a case of a female 15-year-old patient who presented with bleeding gums and an expansile lesion in mandible whose previous investigations elsewhere suggested a malignant lesion. However, further investigations revealed it to be Brown's tumor with primary HPT which is a rare genetic disorder, known as HPT-Jaw Tumor Syndrome (HPT-JT).

Sublingual hematoma is a rare complication of oral anticoagulant use. Spontaneous sublingual hematoma secondary to hypertension is even rarer and their management remains enigmatic. We present such a case that we successfully managed conservatively along with a review of relevant literatures.

Surgical removal of benign tumors of the Parapharyngeal space (PPS) is the treatment of choice. PPS tumors may remain undetected for long periods of time and large tumors in the PPS can extend into the Retropharyngeal Space or into the Infra-Temporal Fossa. Anatomically, the mandible represents a significant obstacle to successful PPS surgery. Except for very small tumors, it is difficult to remove larger tumors from this region without some form of mandibular retraction. The standard mandibular “swing” approach involves splitting of the lower lip and a single parasymphysis osteotomy for retraction of the mandible laterally to expose the PPS. However, the morbidity associated with midline lip split and anesthesia of the hemi-labial region caused by the severing of the mental nerve is an unwanted complication of this approach. In this article, we describe an easier double mandibular osteotomy (Segmental Mandibular Swing Approach) which avoids the morbidity associated with lip splitting or intra-oral mucosal incision but allows excellent exposure of the superior and lateral aspect of PPS for easier removal of large tumors in this region.

Cervical vagal schwannomas are rare, slow growing tumours usually occur in patients between thirty and fifty years of age with no sex related predisposition. They are usually asymptomatic benign lesion and complete surgical resection with preservation of neural pathway, whenever possible is the treatment of choice.