Extrapulmonary small cell carcinomas are extremely rare, accounting for 0.1-0.4% of all malignancies and 2.5-4% of small cell carcinomas. In the head and neck region, the most common primary sites are the larynx, salivary gland, nasal cavity, paranasal sinus, tonsil, and oral cavity. Small cell carcinomas occurring in nasopharynx are exceedingly rare, to our best knowledge, only four cases of primary nasopharyngeal small cell carcinoma have been described in English literature. We report another case of nasopharyngeal small cell carcinoma arising in a 46-year-old woman. She accused, for five months, nasal blockage, right hypacusia, exophthalmos and reduced visual acuity. Cerebral and facial magnetic resonance imaging showed an extensive mass of the nasopharynx with the invasion of the sphenoidal body, the diagnosis of disseminated small cell carcinoma of nasopharynx was established. The patient received three courses of systemic chemotherapy; unfortunately, she died after the third course. The prognosis of such entity is poor and is similar to that for patients with extensive small cell lung cancer.

Multiple Myeloma is a blood cancer type B characterized by clonal proliferation of malignant plasma cells. The median age at diagnosis is 70 years. Cases among younger patients are rare, and less than 0,3% patients are younger than 30 years in most series. We report a case of a 25-year-old women. She was suffering from a sacred pain radiating towards the left lower limb and fatigue for three months. A magnetic resonance imaging for dorso-lumbar spine showed an extensive process and multiple osteolytic lesions in second, third and fourth sacred vertebras. She underwent a laparotomy that revealed a dense mass invading the sacrum and the rectum. The histological examination with immunocytochemistry analysis showed a plasmocytoma and the diagnosis of symptomatic multiple myeloma stages III established than she received two courses of chemotherapy. Despite the rarity of multiple myeloma among young patients, this diagnosis should be evoked when clinical, biological and radiological signs are in favor. It appears that there is no difference between younger and elderly patients on the presentation of the disease, although a longer survival reported among young patients.

Basal cell carcinoma is the most common skin cancer, characterised by a slow growing behavior, metastasis are extremely rare, and it occurs in less than 0, 1% of all cases. Giant basal cell carcinoma is a rare form of basal cell carcinoma, more aggressive and defined as a tumor measuring more than 5 cm at its largest diameter. Only 1% of all basal cell carcinoma develops to a giant basal cell carcinoma, resulting of patient's negligence. Giant basal cell carcinoma is associated with higher potential of metastasis and even death, compared to ordinary basal cell carcinoma. We report a case of giant basal cell carcinoma metastaticin lung occurring in a 79 years old male patient, with a fatal evolution after one course of systemic chemotherapy. Giant basal cell carcinoma is a very rare entity, early detection of these tumors could prevent metastasis occurrence and improve the prognosis of this malignancy.

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