An unusual case of cryptococcosis of the larynx is described in a non-immunocompromised patient. To our knowledge this is the second reported case in the literature.

Fibrous histiocytoma is uncommon in the head and neck region and rare in the larynx. Its behaviour is unpredictable.

A case is reported in a 54-year-old male which was treated conservatively initially and which recurred several times over a seven year period. During that time the appearances of the lesion changed from those of a densely collagenous, cytologically benign tumour to those of a richly cellular and potentially malignant neoplasm. Laryngectomy was eventually undertaken.

An inflatable balloon was inserted through a pre-existing tracheostomy to occlude the upper trachea. This technique controlled previously intractable laryngeal overspill for a period of three months in a patient with inoperable carcinoma of the larynx.

A case of an aggressive supraglottic squamous cell carcinoma, which was managed with neo-adjuvant chemotherapy and radical surgery, is described. The post-operative course was of rapid deterioration and death due to progressive metastatic disease involving bone marrow and liver. This is the first reported case of bone marrow infiltration by squamous cell carcinoma of the head and neck diagnosed ante-mortem. The incidence and pattern of metastatic disease from head and neck tumours is reviewed, and the importance of initial staging in determining the risk of distant metastatic disease is emphasised.

The reported incidence of metastatic disease in head and neck cancer is increasing. The most common site of metastatic involvement in squamous carcinoma of the head and neck is the lung followed by liver, mediastinal nodes and bone. The breast is rarely infiltrated by metastatic disease, 2 per cent or less of clinically detected breast lumps being of nonmammary origin, most frequently malignant melanoma, lymphoma/leukaemia and primary lung carcinoma.

A 73-year-old female presented with a primary posterior pharyngeal wall squamous carcinoma and bilateral enlarged neck nodes. She developed an isolated breast metastasis while receiving palliative radiotherapy and died seven months after presentation.

Clinically detected breast metastasis in head and neck squamous cell carcinoma was first documented by Toombs and Kalisher in 1977. This is the first report of such a case originating in the posterior pharyngeal wall. The prognosis is invariably poor.

Primary mucosal melanoma of the head and neck is rare and few published cases give proof that the mucosal site is primary. We present a man with malignant melanoma of the nasal cavity which was associated with melanoma-in-situ of the adjacent mucosa, proving that the lesion was primary. He presented with symptoms due to secondary deposits of melanoma in the brain rather than the more usual nose bleeds or blocked nose. The primary site wasfound when his neurological symptoms were investigated by CT and NMR scans of the head.

Haemangiopericytoma is an uncommon vascular tumour which has rarely been recorded in the larynx. The diagnostic and histopathological difficulties are discussed. A total laryngectomy was performed because of the size and site of the tumour, the associated risk of local recurrence and the high metastatic rate.