Osteolipomas are rare tumors, particularly in the head and neck region, in contrast to lipomas which are the most common benign neoplasms in this location. Osseous changes are benign and mainly occur in longstanding lipomas. Despite its rarity, this neoplasm has a characteristic histopathologic appearance with lamellar bony spicules within the mature adipose tissue. Of the 19 cases previously reported in the oropharyngeal area, only two were located in the submandibular region. We report the third case of submandibular osteolipoma, presenting as an asymptomatic mass in a middle-aged man. Our review of head and neck osteolipomas would be of particular interest to pathologists and head and neck surgeons, in order to avoid inappropriate treatment of an otherwise benign lesion.

An 8-year-old white male was referred to our clinic for a 1-year history of decreased appetite and no weight gain. His entire workup failed to demonstrate cystic fibrosis, or any infectious or immune-related diseases. Chest imaging and clinical picture suggested parenchymal lung disease. Histopathology examination of the video-assisted thoracoscopic biopsy of his lungs showed a desquamative interstitial pneumonia (DIP)-like pattern that resembled that of adult smokers with the same disease. Genes for surfactant proteins B and C and the transporter ABCA3 were all negative. Furthermore, lack of any genetic disorder for surfactant proteins, along with his history of heavy exposure to 10 pack-years of indoor secondhand smoke suggests that this child's DIP is due to secondhand cigarette exposure. He had nearly complete resolution of his symptoms after a year of treatments with pulse steroid and hydroxycholoroquine. To the best of our knowledge this is the first case of cigarette smoke-related DIP reported in a child.