Tuberculous mastitis is a rare clinical entity and usually affects women from the Indian sub-continent and Africa. It often mimics breast carcinoma and pyogenic breast abscess clinically and radiologically, may both co-exist. Routine laboratory investigations are not helpful in its diagnosis. Fine needle aspiration cytology (FNAC) / biopsy are essential for diagnosis and tuberculosis culture when positive may be very useful to guide antimicrobial therapy. Antitubercular drugs in combination with aspiration or surgical drainage are usually associated with an excellent outcome.

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Tuberculosis of the submandibular salivary gland is a rare condition and only a few cases have been reported in literature. Tubercular sialadenitis is most frequently seen in immunosuppressed patients. Diagnosis of this disease is difficult. Although fine needle aspiration cytology is useful in diagnosis, excisional biopsy is often required. Polymerase chain reaction for mycobacterium tuberculosis is a reliable diagnostic tool, and if available, it should be performed before surgical intervention to enable differential diagnosis of a salivary gland tumor. We report two cases of the submandibular salivary gland tuberculosis from South India (Mangalore located in the coastal belt of Karnataka) that proved diagnostically challenging. Both patients responded well to antitubercular therapy and surgery was avoided.