Salivary gland diseases are diverse, including neoplastic, cystic and inflammatory diseases, and are often difficult to diagnose. Ranula is a mucous retention cyst often encountered clinically. Sialolithiasis is usually caused by the submandibular gland; reports identifying the sublingual gland as the cause are low at 0 to 6.4%. To date, there has only been one case report of a combination of ranula and sialolith. We report a case of sublingual-plunging ranula containing sialoliths with ossification. The patient was a 17-year-old female referred to our hospital with painful swelling in the right submandibular region. The clinical findings included mild swelling of the right submandibular region, and a sialolith-like hard substance palpable in the right floor of the mouth. Contrast-enhanced computed tomography and contrast-enhanced magnetic resonance imaging showed a cyst-like lesion from the right sublingual space to the submandibular space, and three sialolith-like calcifications were found in the cyst. The clinical diagnosis was right-sided sublingual-plunging ranula containing multiple sialoliths, and the patient underwent a sublingual gland excision, ranula excision and salivarylithotomy under general anesthesia. The resected specimen showed three stones encapsulated in the cyst contiguous to the sublingual gland.

Langerhans cell histiocytosis (LCH) is a rare proliferative disorder characterized by the accumulation of Langerhans cells, and wide-ranging organ involvement. In the oral and maxillofacial region many cases have been reported in the hard tissue of jaws; cases occurring in facial soft tissue are rare. We report a case of LCH arising in the facial soft tissue of a 26-year-old man who presented with an ulcerative lesion on the lower lip and erythema around the left eyelid skin.

　Tissue biopsies of both the lower lip and left eyelid skin lesions were performed, and a histological diagnosis of LCH was obtained for both lesions. The lesion on the lower lip was treated by corticosteroid injection, and the lesion around the left eyelid skin was treated by corticosteroid ointment. One month later, the lesion on the lower lip had shrunk, and the lesion around the left eyelid was improving. The patient was followed up for eight years after the treatment, and there was no recurrence or appearance of lesions in any other organs. Although skin-mucosal limited LCH usually indicates an indolent clinical course, there is a secondary risk of developing hematopoietic tumors and long-term follow-up is required.

The maxillary swing approach (MSA) allows access to the retromaxillary area, pterygopalatine fossa, nasopharynx and the infratemporal fossa through temporary disarticulation and lateral swing of the maxilla with the attached facial skin. We report a case of resection of a maxillary tumor occupying a wide area of the maxillary sinus using a modified MSA.

　A 33-year-old male was referred to our department in February 2019 complaining of nasal obstruction on the right side. Intra-oral examination revealed a 34×22 mm mass in the right upper alveolar ridge. I maging revealed an expansile lesion with calcification in the posterior wall of the right maxilla and antrum, extending to the orbital floor and nasal cavity. A biopsy resulted in a histopathological diagnosis of fibro-osseous lesion. Since the anterior portion of the right maxilla was not involved, a partial maxillectomy using a modified MSA was performed. Good functional and esthetic results were obtained due to preservation of the anterior portion of the maxilla. There was no evidence of recurrence as of four years after the operation.

A 72-year-old female with a tumor in the lower gingiva was referred to our department for consultation. A clinical diagnosis of squamous cell carcinoma of the right lower gingiva (cT2N0M0) was made, and a marginal madibulectomy and elective neck dissection were performed. The histopathological diagnosis of the resected specimen was acantholytic squamous cell carcinoma (ASCC). A month after the surgery, local recurrence and bilateral cervical lymph node metastases were found. The patient underwent a mandibular segmental resection and bilateral neck dissection, and immediate reconstruction with a rectus abdominis myocutaneous free flap. Although we planned to perform chemoradiotherapy, local recurrence and multiple metastases were observed and the patient died five months after the initial diagnosis. The autopsy revealed cervical lymph node metastasis and distant metastases to the skin, lung, pleura and mesentery.