Craniofacial fibrous dysplasia commonly affects the larger mandible and the maxillary bones. Although involvement of the frontal, temporal and sphenoid bones has been described, fibrous dysplasia of the nasal bone has not been previously described; the two cases reported here have been made rarer by their isolated involvement. Clinical management is dependent on disease activity and patient symptoms.

To present two cases of isolated fibrous dysplasia of the nasal bone: a 46-year-old woman with gradual widening of the nasal bridge and a 47-year-old man with an incidental finding of a nasal bone mass.

Two case reports.

The 46-year-old woman underwent excision of the lesion while the 47-year-old man opted for watchful waiting.

We have presented the first case reports of fibrous dysplasia of the nasal bone. The care of these patients should be customised to their needs and wishes.

To explore the diagnosis and treatment of carcinosarcoma of the larynx.

Clinical information, including presentation, pathology, treatment and outcome, was obtained from a review of patient charts.

Seven male patients were confirmed pathologically to have had carcinosarcoma between 2003 and 2009 in our hospital. All patients underwent surgery: four total laryngectomies, two vertical partial laryngectomies, and one supracricoid partial laryngectomy-cricohyoidopexy. The mean follow up was 40.6 months. At the time of writing, six patients were alive and being followed; two of these suffered regional metastasis to the cervical lymphatic nodes and underwent radical neck dissection. One patient died of multiple distant metastases 60 months post-operatively.

Carcinosarcoma of the larynx describes a biphasic tumour showing both carcinomatous and sarcomatous differentiation. It is extraordinarily rare and prone to metastasise to the cervical lymph nodes. Complete surgical resection of laryngeal primary lesions with wide margins and suitable neck dissection of cervical nodes is reasonable therapy.

Parapharyngeal space tumours are uncommon and represent 0.5–1 per cent of all head and neck neoplasms; 20–30 per cent of these are malignant. Malignant peripheral nerve sheath tumours are rare and mostly encountered in patients with neurofibromatosis type 1. Only four cases of parapharyngeal space tumours have been reported in the English language in patients without neurofibromatosis type 1.

We report the case of a 64-year-old man with no stigmata of neurofibromatosis type 1, in whom a mass in the left pre-styloid region of the parapharyngeal space was an incidental finding following magnetic resonance imaging for investigation of cervical spine problems. The mass was consequently removed using a transcervical approach. A histological review revealed a low-grade malignant peripheral nerve sheath tumour.

We consider the pathophysiology of this highly malignant tumour as well as the challenging anatomy of the parapharyngeal space and the surgical and other therapeutic modalities utilised to treat this condition.