A case report of a patient with adenocarcinoma of the breast with matastasis to the nasopharynx is described. The patient presented initially with pulmonary metastasis followed later by metastasis to the left jugulo-digastric lymph nodes. A prominent but asymptomatic nasopharyngeal mass was concomitantly discovered on head and neck examination. Three months later, symptoms of panhypopituitarism developed. Invasion of the base of the skull and pituitary were documented. Patients with adenocarcinoma of the breast and high cervical node metastasis should have a thorough otolaryngologic and head and neck evaluation.

Metastatic carcinoma to the nasopharynx is an extremely rare occurrence. Only two cases of bronchogenic carcinoma of the lung and two cases of hypernephroma metastatic to the nasopharynx have been reported in the literature (Bernstein et al., 1966). We present what we believe to be the first case of metastatic adenocarcinoma of the breast to the nasopharynx.

Chondrogenic neoplasms of the nasal cavity are rare. Clinically, presentation is often late, with expansion and destruction of the middle facial skeleton. Local radical surgical excision is the preferred treatment, with regular life-long follow-up. Risk of local recurrence and distant metastases may Qccur many years after initial treatment. All chondrogenic tumours should be carefully followed up because the natural course of the disease may not match the histological differentiation.

An unusual squamous cell carcinoma of the larynx containing numerous multinucleated osteoclast-like giant cells in described. These cells occurred in areas of vigorous angiogenesis and haemorrhage. To our knowledge, this is the first case of laryngeal squamous cell carcinoma with osteoclast-like giant cells reported in the literature. The patient has remained alive and free of clinical disease 5 years and 4 months after the original diagnosis.

Major salivary glands have been rarely reported as sites of necrotizing sialometaplasia, a disease primarily affecting minor salivary tissue, particularly that of the palate. Eight cases of necrotizing sialometaplasia of the parotid and submandibular glands are presented and added to six reported earlier by Donath (1979). The clinical and pathologic findings in the 14 cases give strong support to the vascular-based-infarct genesis of necrotizing sialometaplasia.

Abstract A laryngectomized patient who developed massive subcutaneous emphysema, pneumothorax, pneumomediastinum, and esophageal fistual with a retroesophageal collection following the creation of a tracheo-esophageal fistuls for alaryngeal voice restoration is presented, together with its management. A review of the literature is made, and possible causes of the three complications are discussed.