Metastasis to skin sites is an uncommon feature of SCCHN. SM may represent the first clinical evidence of impending loco-regional recurrence or distant metastasis. The development of SM is an ominous sign associated with an extremely poor prognosis, similar to the development of distant metastasis at more typical sites. Both the development of SM and survival of patients developing SM are independent of primary tumor stage. Current treatment options of SM are limited in their efficacy.

This study demonstrates that the position of hypertrophied adenoids may alter the final otologic outcome of patients requiring PET insertion for OM. Patients with adenoids abutting the torus tubaris may benefit most from an adjuvant adenoidectomy.

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The physician evaluating a patient with SP should be aware of the features described and of their possible association with a malignant lesion.

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Despite the decline of pulmonary tuberculosis in the Western world, the incidence of cervical mycobacterial infections has remained relatively unaffected. A retrospective review was conducted of 20 patients treated for head and neck tuberculosis from 1984 to 1991. They were mostly an immigrant group coming from underdeveloped countries close to the equator. All cases were treated with antituberculous chemotherapy; 18 patients also underwent surgical excision of their lymphadenopathy. Sixteen patients showed complete response to combined treatment and one relapse was successfully retreated with antituberculous medication. Three patients died from unrelated causes--two from human immunodeficiency virus infection and one from nasopharyngeal carcinoma. The most reliable indicator of mycobacterial infection was the pathologic specimen, making the need for surgical intervention an important diagnostic consideration. As with other reports, most patients in our series had negative chest x-ray films, variable responses to skin testing, and negative cultures. The epidemiology, pathogenesis, and management of this disease are discussed.

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Fewer than 15% of lipotnas occur in the head and neck. To date, fe wer than 100 cases oj laryngeal lipoma ha ve been reported in the lite rature. Typi cal clinical nianifestations include dysp hag ia, dyspnea and hoarseness, as well as the presence oj a smoo th or pedun culated mass seen endos copically and a low attenuation mass on computed tomography scan. Pathologic sections commonly reveal a tumor consisting ofmatu re adipocytes, which is often encapsulated. Treatm ent of laryn geal lipoma varies fro m conservative total endos copi c removal to externa l surgical approaches. The fo llow ing is a report ofa single case oflaryngeal lipoma, including pathologic and radiologic fin din gs, as well as a review oj the literature.