Parotid tumors usually present as a unilateral, solitary mass. Bilateral occurrence accounts for 1-3% of cases of parotid tumors, mostly adenolymphomas (Warthin's tumor). We report a very rare case of bilateral malignant parotid tumors with different histological types.
A 68-year-old male visited our hospital complaining of right parotid swelling. Imaging studies showed bilateral parotid tumors. Resection of the right parotid tumor, which was growing rapidly, was performed under general anesthesia. The pathological diagnosis was acinic cell carcinoma. About 1 year after the first surgery, resection of the left parotid tumor was performed under general anesthesia. The pathological diagnosis was carcinoma in a pleomorphic adenoma. The postoperative course was uneventful, and the patient has been well without recurrence.

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A case (74-year-old male) of multifocal Warthin's tumors arising from unilateral submandibular and parotid glands is reported. There extirpated masses, which were elastic soft, well-demarcated and movable, measured about 3, 2 and 0.5cm in ediameter. Though these tumors were clinically suspected to be reticuloendothelial system tumors, all tumors were histologically diagnosed as Warthin's tumor.
Of these masses, the two were considered as tumors originating from submandibular gland with pathogenetic aspects from pre- and postoperative CT findings and operation states.

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A 71-year-old male developed squamous cell carcinoma of the right cervical area. Because of a suspicion that he suffered multiple intratracheal metastasis, he was treated by chemotherapy alone. He received combination chemotherapy including 5-FU and nedaplatin (CDGP), with methotrexate (MTX) and leucovorin (LV) as biochemical modulation. One course of the chemotherapeutic regimen consisted of MTX 150mg/body 1hr div. +5FU 600-750mg/body 2hr div. followed by 5FU 3000mg/body 72hr div. with 15 times of LV 15mg/body iv+CDGP 80-100mg/body 2hr div. After 4 cycles of the MTX-5FU-CDGP therapy (total dose: MTX=600mg/body, 5FU=14550mg/body, CDGP=380mg/body), the tumor was remarkably reduced in size and showed a complete response (CR) on CT scan. The CR is being maintained as of this writing, at one year after the therapy.

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A 53-year-old male visited our hospital with a complaint of a painless swelling in the left cheek. Biopsies were performed twice showing chronic inflammation and no evidence of malignancy.
About two years later, he suffered from writing and speaking disturbances. Tumor extirpation was done due to diagnosis of intracranial middle fossa tumor, and diffuse large B-cell lymphoma was diagnosed from surgical specimen.
Since bilateral swelling of the cheek and trismus arose after the surgery, malignant lymphoma was suspected and biopsy was performed, however, it was not malignant. Six courses of chemotherapy with VEPA-M (VCR, CPA, PDN, ADM and MTX) were performed successfully. During the chemotherapy, an excisional biopsy of one of the enlarged left cervical lymph nodes was performed and diagnosis of B-cell small lymphocytic lymphoma was made.
However, tumor recurred in the left parotid region three months after the chemotherapy. Despite of salvage chemotherapy with IMVP-16 (IFX, MTX and VP), the patient died of multiple organic failure.

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