Background: Mucoepidermoid carcinoma (MEC) is the most common malignant salivary gland tumor, representing approximately 30–35% of all salivary gland malignancies. Primary intraosseous MEC of the jaws is an exceptionally rare entity, with fewer than 200 cases reported in the literature since its first description in 1939. Its clinical presentation is often nonspecific, contributing to delayed diagnosis and potential mismanagement. Objective: To highlight the diagnostic challenges and clinical significance of atypical presentations of intraosseous mandibular MEC, particularly those associated with neurological manifestations. Materials and Methods: We report a case of primary intraosseous MEC of the mandible with unusual clinical features, emphasizing the diagnostic process, radiological and histopathological findings and therapeutic management. Results: Intraosseous MEC typically presents as a slow-growing, painless swelling in the posterior mandible, often mimicking benign odontogenic lesions. Neurological symptoms are uncommon and usually limited to inferior alveolar nerve involvement, presenting as hypoesthesia or paresthesia. In this case, the presence of facial nerve palsy as an initial symptom represented a rare and alarming feature, suggesting advanced disease or neural invasion. Imaging and histopathological examination confirmed the diagnosis, guiding appropriate surgical management. Conclusion: Intraosseous MEC of the mandible remains a diagnostic challenge due to its rarity and nonspecific clinical presentation. The occurrence of facial nerve palsy as an initial manifestation is exceedingly rare and should raise suspicion for aggressive disease. Early recognition and comprehensive evaluation are essential to ensure accurate diagnosis and optimal management.

Familial hypercholesterolemia (FH) is a genetic disorder characterized by hyper low-density lipoprotein cholesterolemia (LDL-C) and associated risk of premature atherosclerosis. In our case the child presented with generalized body aches and on examination xanthomatosis was present. Acyanotic congenital heart disease (ACHD) was an associated co morbidity which was surgically repaired two years back. The child was not on statins and laboratory evaluation revealed hyper-low-density lipoprotein cholesterolemia. Genetic evaluation was done in which no genetic mutation was reported. For atherosclerotic changes, evaluation was done which came out to be normal. On familial survey, LDL-C was found to be raised in both mother and father with positive history of consanguity. Child was started on statins. In our case, further genetic evaluation could not be performed due to financial constraints. However, the clinical picture and laboratory evaluation strongly suggested the diagnosis of homozygous FH. HoFH is a difficult to treat disease with poor response to medical therapy leaving us with only few treatment modalities like lipoprotein apheresis and novel agents. Therefore, in these patients timely screening and early intervention is crucial for prevention of atheroscelerotic cardiovascular disease (ASCVD).

Poland syndrome is a rare congenital disorder typically characterized by unilateral absence or hypoplasia of the pectoralis major muscle, often accompanied by ipsilateral hand anomalies such as brachydactyly or syndactyly. While its clinical presentation is relatively well defined, associations with other congenital defects are uncommon. We report the case of an 18-year-old male who presented with left-sided chest wall asymmetry and brachydactyly, consistent with Poland syndrome, along with the novel finding of ipsilateral congenital ptosis—a feature not previously documented in the medical literature. Detailed physical, neurological, and ophthalmologic examinations, along with imaging studies, confirmed the diagnosis and ruled out other neurological etiologies. The absence of functional impairment led to conservative management with clinical monitoring. This case expands the known phenotypic spectrum of Poland syndrome and underscores the importance of thorough clinical evaluation in detecting atypical manifestations of rare congenital anomalies.

Tuberculosis remains global health concern with diversity in its clinical presentation and Parotid tuberculosis is rare form of extrapulmonary tuberculosis which poses challenges in its diagnosis. We present case of 14  year female pressing with parotid swelling diagnosed on cytological examination and patient started on antitubercular treatment.