More than half of patients with oral cancer recur even after multimodality treatment and recurrent oral cancers carry a poorer prognosis when compared to other sites of head and neck. The best survival outcome in a recurrent setting is achieved by salvage surgery; however, objective criteria to select an ideal candidate for salvage surgery is difficult to frame, as the outcome depends on various treatment-, tumor-, and patient-related factors. The following is summarizes various tumor- and treatment-related factors that guide our decision-making to optimize oncologic and functional outcomes in surgical salvage for recurrent oral cancers. Short disease-free interval, advanced tumor stage (recurrent and primary), extracapsular spread and positive tumor margins in a recurrent tumor, regional recurrence, and multimodality treatment of primary tumor all portend worse outcomes after surgical salvage. Quality of life after surgical intervention has shown improvement over 1 year with a drastic drop in pain scores. Various trials are underway evaluating the combination of immunotherapy and surgical salvage in recurrent head and neck tumors, including oral cavity, which may widen our indications for salvage surgery with improved survival and preserved organ function.

Osteosarcoma is the most common bone malignancy and it is rarely studied in head and neck. In head and neck, the most common sites are maxilla, mandible and skull bones. The treatment strategies are based on metanalysis on osteosarcoma of extremities. The prognosis and survival depend on the surgical margins. Due to complexities in anatomy, local recurrence is the most common pattern of failure in head and neck. This study outlines the management protocol of osteosarcoma mandible at our institute and a review of literature on osteosarcoma mandible is discussed.

The matured salivary gland contains two types of cells, both luminal and abluminal cells. The luminal cells include acinar and ductal cells. The abluminal cells are myoepithelial and basal cells. 4 Unlike salivary glands, mammary glands undergo complex epithelial remodeling throughout puberty, pregnancy, lactation, and weaning. The mammary gland is a highly branched ductal structure having luminal cells and myoepithelial cells. 5 Each cell type in both mammary and salivary glands express a variety of markers that helps in the identification and characterization (Table 1) and (Table 2). [6][7][8] Salivary gland tumors are distinct in their wide variety of subcategorization and rarity in occurrence. The two most widely IntroductIonSalivary glands are complex tubuloacinar exocrine or merocrine glands mainly secrete saliva. The parotid gland is ectodermal, while submandibular and sublingual glands are endodermal in origin. All the minor salivary glands have mixed origins with both ectodermal and endodermal components. The epithelial cells determine the type of secretion produced by the gland and the mesenchymal cells contribute to the morphology of the gland. 1 Each developed gland consists of parenchyma, glandular secretory tissue, and stroma. The secretory units contain secretory cells which organize to form clusters called acini. These units can be either of the three types-mucinous, serous, and seromucinous. The secretions pass through the intercalated ducts, striated, excretory duct, and finally main excretory duct opening into the oral cavity. 2 The mammary gland contains both ectodermal and mesodermal components. The ectoderm forms a mammary line which resolves into placodes. These placodes invaginate into the mesenchyme and form the rudimentary ductal structure. The embryonic mammary mesenchyme provides the key signals for epithelial cell differentiation. This epithelial differentiation was demonstrated in reciprocal tissue recombination experiments in which 12 and 16th-day-old embryonic mammary epithelium was combined with salivary mesenchyme and grown in culture. These tissue recombinants produced epithelium that was morphologically resembling salivary glands. The rudimentary ductal system forms the terminal end buds which later differentiate to form myoepithelial cells. This system will develop into terminal ductolobular units with acini which are mainly mediated by hormones. 3

<p class="abstract"><strong>Background:</strong> The objective was to determine the incidence of second primary in patients with squamous cell carcinoma larynx and hypopharynx following surgical management with or without adjuvant treatment.</p><p class="abstract"><strong>Methods:</strong> A retrospective quantitative descriptive study was conducted on 289 patients who underwent surgical management of squamous cell carcinoma (SCC) of larynx and hypopharynx with or without adjuvant treatment and later developed second primary. This study comprised of patients undergoing treatment during the time period of January 2016 to January 2019 at the department of head and neck surgery, Kidwai institute of oncology.</p><p class="abstract"><strong>Results:</strong> Second primary malignancies (SPM) developed in 3.1% of patients within a median follow up period of 28 months. Majority of the second primaries developed in patients with hypopharyngeal malignancy.</p><p class="abstract"><strong>Conclusions:</strong> SPMs are amongst the leading causes of mortality in patients with SCC larynx and hypopharynx. Hence careful surveillance is essential for the early detection of a second primary.</p>

Salivary gland tumors are a heterogeneous group of tumors in the head and neck; most of the malignant tumors have a poor prognosis and limited long-term survival. The recent 2017 WHO classication had made few changes in the sub-categorization and modied some terms. More studies are underway in the eld of molecular level changes and responses to targeted therapies in these tumors. These researches have shown some resemblance in the behavior of salivary gland and breast carcinomas, leading to a new line of thinking in terms of hormonal therapy. This study outlines 14 cases of rare parotid tumors reported in our institute during the time period of 2018 to 2020 and a comprehensive review on salivary gland tumors, newer entities added, and newer treatment strategies.