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We report the case of a man presenting with a large, airway obstructing, minor salivary gland tumour arising from the right tonsillar base. Clinically, the tumour behaved in a malignant way. A firm diagnosis of malignancy could not be made histologically. The differential diagnosis included polymorphous low-grade adenocarcinoma, basal cell adenoma and adenoid cystic carcinoma. However, on balance, based on the clinical presentation, a diagnosis of malignancy was favoured and appropriate treatment was considered. Because of the patient's co-morbidities, further surgery was not an option and it was agreed that the patient should undergo radiotherapy instead. While he was waiting for radiotherapy, the tumour went into remission.