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Schwannoma can arise from any cranial, peripheral or autonomic nerve, except the olfactory and optic. About 25-45% of extracranial schwannomas lie in the head and neck. Data on malignant schwannoma from low-income settings are inconsistent. We reported a case of giant periorbital malignant schwannoma successfully treated in a low-income setting. The strength of our case is given not only by the rarity and the size of the disease but also for highlighting the weakness of health system in low-resource settings. It is mandatory to strengthen the health system with particular attention to physical, psychologic and social aspects and to promote comprehensive programs including all these aspects., Competing Interests: Conflict of interestThe authors declare that they have no conflict of interest., (© The Association of Oral and Maxillofacial Surgeons of India 2019.)

Cholesteatoma is a pathological tissue that may extend into all parts of temporal bone and rarely, as this study highlights, beyond its structures. Nevertheless, the spread outside the mastoid tip into the soft tissues of the neck or parotid space is very rare. The case of 23-year-old male with right parotid mass is presented. The patient had history (2006, 2009, and 2012) of three tympanoplastics for recurrent right ear cholesteatoma. The parotid tumor was revealed incidentally in magnetic resonance imaging in January 2016, but the imaging was inconclusive. After 6 months, the patient developed right-sided facial nerve palsy. The second look of the right ear was performed with simultaneous parotid surgery. The ear was healed and free of cholesteatoma, but the parotid mass resembled the cholesteatoma confirmed later on by histological examination. The tumor extended from stylomastoid foramen. This case was unusual as the disease had extended beyond the ear with the bony parts of the mastoid being preserved. To our knowledge, this is the first case report to describe a parotid gland cholesteatoma not being an extension of a cholesteatoma present in the tympanic cavity and entering the parotid gland via stylomastoid foramen., Competing Interests: Declaration of conflicting interests: The authors declare that they have no conflicts of interest. This article does not contain any studies with animals performed by any authors.