Papillary Variant of Nasopharyngeal Carcinoma: An Unusual Variant Previously Unreported in Malaysia

@#Nasopharyngeal carcinoma is a commonly encountered malignancy in endemic regions of the world namely South East Asia, China and Hong Kong. In Malaysia, the ethnic Chinese population is particularly at risk due to genetic susceptibilities and environmental exposure to carcinogenic agents. We herein report a case of nasopharyngeal carcinoma in a middle-aged man of Malay ethnicity who presented with nasal blockage and neck nodes. The biopsy of the nasopharyngeal mass came back as papillary variant of nasopharyngeal carcinoma. The commonly reported histopathological types are the keratinizing and non-keratinizing types, and rarely the basaloid type. In this case report, we aim to highlight one of the rare variants of the non-keratinizing nasopharyngeal carcinoma. When diagnosing the non-keratinizing type, appreciation of the different morphological variants is crucial not only to help aid in procuring an acurrate histopathologic diagnosis, but also to help in subsequent treatment plan.

A rare case of large submandibular sialolith with spontaneous extrusion

Sialolithiasis is one of the commonest disease of salivary glands. Submandibular salivary gland or its duct is a major site of sialolithiasis and it is always leads to sialadenitis. However large sialolith formation and self-extrusion is a rare condition. A case of submandibular sialolithiasis is reported where patient presents with recurrent submandibular swelling and subsequently end up with a spontaneous extrusion. The mechanisms and management of the salivary gland calculi are also discussed.

Endoscopic removal of an extensive sinonasal schwannoma

Schwannoma is a rare, benign and slow-growing tumour which arises exclusively from Schwann cells. Essentially this tumour can be found in any part of the body. In the paranasal sinuses and nasal cavity, this tumour originates mostly from the ophthalmic and maxillary branches of the trigeminal nerve. The most common clinical presentation is unilateral nasal obstruction. Histological examination is crucial for diagnosis. The main modality of treatment is surgical excision. The type of surgery will depend on the location and extent of the tumour. Even though it is generally considered a benign tumour, there have been reports of potential malignant transformation. We report a case of a 52-year-old man with an extensive nasal mass which was removed endoscopically and histologically confirmed as schwannoma.

Lateral tracheostomy in an extensive cutaneous hemangioma patient

Midline tracheostomy is a common procedure in Otorhinolaryngology. The indication varies from one patient to another. It is performed mainly in emergency situations to provide effective airway. Some elective surgery for example surgery involving oral cavity may need tracheostomy. However, in some cases, lateral tracheostomy may be needed. We describe a case of a man with extensive cutaneous hemangioma crossing midline in which a lateral tracheostomy is needed