The authors report clinical experience in managing an 82-year-old female presenting with long-standing bilateral nasal obstruction resulting from a nasopharyngeal mass. The patient had undergone a number of treatments including surgery. The previous examinations, investigations and treatment had all been performed within the previous 10 years and although examination had been documented there was no evidence on review of the notes that the nasopharynx had been inspected either by nasendoscopy or indirectly. The mass was removed via a combined nasal and oral approach. Histopathological examination of the specimen was consistent with mesenchymal hamartoma. In addition to describing a rare presentation the authors believe this case highlights the importance of complete examination in all patients with nasal symptoms.

We report the case of a man presenting with a large, airway obstructing, minor salivary gland tumour arising from the right tonsillar base. Clinically, the tumour behaved in a malignant way. A firm diagnosis of malignancy could not be made histologically. The differential diagnosis included polymorphous low-grade adenocarcinoma, basal cell adenoma and adenoid cystic carcinoma. However, on balance, based on the clinical presentation, a diagnosis of malignancy was favoured and appropriate treatment was considered. Because of the patient's co-morbidities, further surgery was not an option and it was agreed that the patient should undergo radiotherapy instead. While he was waiting for radiotherapy, the tumour went into remission.

No abstract