We present a 42-year-old male with botryomycosis initially presenting with left-sided proptosis due to an infraorbital mass. A biopsy through an anterior orbitotomy yielded indeterminate histopathology. The patient later developed a similar oral lesion which was biopsied and found to be botryomycosis. The oral lesion recurred after initial surgical treatment, but responded to antibiotic therapy. Discussion of this case along with a review of the literature is presented to offer guidelines for recognition and managment of this rare disorder.

Primary branchial cleft carcinoma is a diagnostic challenge. The majority of cases have been shown, following the application of rigid criteria, to have developed from an occult metastasis elsewhere.

We describe what we believe to be only the second reported case in a patient who fulfils all of the established criteria.

Vagal paraganglioma is a rare usually benign tumour of neural crest origin. The malignant form of this tumour i s very uncommon and the diagnosis is made on the basis of its clinical behaviour rather than its histological appearance. We report a case of vagal paraganglioma metastatic to adjacent cervical nodes and discuss the diagnosis and management of this tumour.

A case of atypical carcinoid tumour of the larynx in a 72-year-old woman is presented. The neoplasm was located in the supraglottic region and was first manifest by metastases to the scalp. The presence of amyloid-like material and calcitonin-positive cells were features that resembled medullary carcinoma of the thyroid. Clinically, it pursued an aggressive course that led to death 58 months after diagnosis. The literature is reviewed, particularly that regarding the differential diagnosis.