Primary thyroid leiomyomas are rare, and only four cases have been reported to date. This is a report of an additional case of primary thyroid leiomyoma in a 40-year-old male who was admitted with a painless swelling in the right thyroid lobe and underwent subtotal thyroidectomy. The surgical specimen showed a well-circumscribed, greyish-white solid nodule. Histologically, the tumour was composed of spindle cells with blunt-ended nuclei that were arranged with short intersecting bundles.

Immunohistochemical staining revealed reactivity with smooth muscle actin, vimentin and desmin. Histopathologic and immunohistochemical assessments produced the diagnosis of thyroid leiomyoma.

Although primary thyroid leiomyoma is rare, it should be considered in the differential diagnosis of a cold thyroid nodule.

Leiomyomas of the nasal cavity are very rare. A case of leiomyoma arising in the nasal septum is presented. The tumour was removed by endoscopic sinus surgery. The literature on the topic is reviewed.

Two cases of laryngeal smooth muscle tumours are reported: one a benign leiomyoma, the other a malignant leiomyosarcoma. These tumours may present diagnostic difficulties and immunocytochemistry is helpful in distinguishing smooth muscle tumours from other connective tissue neoplasms and spindle cell squamous carcinoma. Primary treatment in both cases should be surgical resection with small (T1, T2) malignant tumours suitable for partial laryngectomy. Postoperative radiotherapy may have a role in allowing a more limited surgical resection.

We present a 68-year-old woman with a vascular leiomyoma of the larynx, a benign tumour that rarely involves that organ. Chief complaints were a feeling of a narrowing of the pharynx and difficulty in breathing in the supine position. A spherical tumour measuring 1.5 cm and covered with normal mucosa was found avthe margin of her epiglottis. The patient was administered a general anaesthetic and the tumour was successfully removed via direct laryngoscopy. Histological examination revealed that the tumour lay beneath a layer of stratified squamous epithelium and was encased in a welldefined fibrous capsule. The tumour parenchyma was composed of proliferated fibres that consisted of elongated cells, surrounded by an abundance of blood vessels. Its complete removal is the treatment of choice with care taken to avoid profuse bleeding. Recurrence is rare.

The paranasal sinuses are a rare site for tumours of myogenic origin. There has been only one previously reported case in the English literature. We present a case of a leiomyoma filling the anterior ethmoid sinus and middle meatus which was excised via a Patterson's external ethmoidectomy.

Leiomyomas of the nose, nasopharynx and paranasal sinuses are rare. So far only two atypical leiomyomas at these sites have been reported in the English literature. A new case is presented and the literature on the subject is reviewed.