We report two cases of branchial cleft abnormalities investigated using magnetic resonance imaging.

There appears to be no clear imaging technique that is universally recommended for imaging branchial cleft abnormalities. Options include fistulography, computed tomography, magnetic resonance imaging and ultrasonography.

Case reports and literature review.

Two cases, although not unusual in themselves, are described to illustrate the use of magnetic resonance imaging to define the anatomy and to assist surgical planning.

Magnetic resonance imaging is able to accurately depict the extent and course of branchial cleft abnormalities, and in the current cases could have been relied upon to determine the necessary surgical procedure. Branchial cleft abnormalities are sufficiently rare for magnetic resonance imaging to be recommended as the first-line imaging modality.

We report the first documented case in the world literature of primary extra-pulmonary small cell carcinoma occurring in the neopharynx following laryngectomy.

We present a case report and a review of the world literature regarding the management of tumours of the neopharynx and extra-pulmonary small cell carcinoma.

The paucity of cases of extra-pulmonary small cell carcinoma has resulted in many departments managing this neoplasm similarly to pulmonary small cell cancer. However, the site of the primary can have an impact on disease survival and treatment options.

Neopharyngeal small cell carcinoma has not previously been reported. It should be managed in the same way as other extra-pulmonary small cell carcinomas occurring within the pharynx or larynx, with combined multi-drug chemotherapy and radiotherapy. Surgery has a limited role due to the aggressiveness of the disease and the high risk of local and distant spread at presentation.

We report a case of spontaneous pneumomediastinum presenting with chest and anterior neck pain.

The clinical findings, differential diagnosis and selection of radiological investigations are discussed.

Spontaneous pneumomediastinum is an uncommon condition usually presenting in young patients. Presentation to the otolaryngology department occurs due to the presence of symptoms such as neck pain. Differential diagnoses must be considered and excluded, using the clinical features and the results of radiological investigation. Once the diagnosis is confirmed, conservative management is undertaken.

Spontaneous pneumomediastinum is uncommon and the clinical features are variable. The recommended investigation is a computed tomography scan with orally administered, water soluble contrast to exclude important differential diagnoses and thus enable definitive diagnosis.

We report the first case of a laryngeal composite tumour consisting of a squamous cell carcinoma combined with an atypical carcinoid.

Case report and review of the literature concerning laryngeal composite tumours.

Primary laryngeal carcinoma is the most common malignancy of the upper aerodigestive tract. The vast majority are of the squamous cell type. Primary neuroendocrine neoplasms represent a rare, heterogeneous subset of laryngeal malignancies, comprising typical carcinoid, atypical carcinoid, small cell carcinoma and paraganglioma. Primary combined neuroendocrine and squamous cell carcinoma of the larynx is even more rarely encountered, with only 14 publications of this so-called composite tumour to date. In each case, the neuroendocrine component has been small cell carcinoma.

The treatment of primary neoplasms comprising more than one histological type is tailored to the most biologically aggressive tumour. Accurate diagnosis of the histological nature of laryngeal composite tumours is imperative to ensure optimal therapy.

We report a rare case of new bone formation (osteogenesis) within an inverted papilloma, occurring in the ethmoid and frontal sinuses.

The histopathological and radiological findings, differential diagnosis, and treatment of tumour-induced osteogenesis are discussed.

A 68-year-old man complained of headache and left-sided, purulent rhinorrhoea of five years' duration. On nasal endoscopy, lesions similar to inflammatory nasal polyps were seen. Pre-operative radiological images demonstrated opacification of the left nasal cavity and anterior ethmoid and frontal sinuses, plus a bone-density lesion. The mass with bony lesion was completely removed endoscopically. The mass was histopathologically diagnosed as an inverted papilloma surrounding bony tissue. Furthermore, the histopathological findings (including immature bony tissue rimmed by osteoblasts) indicated an extremely rare case of inverted papilloma induced osteogenesis. Six months after surgery, no recurrence was detected.

This case highlights the importance of clinical awareness of tumour-induced osteogenesis.