Feta l rhabdotnyoma is not generally considered part of nevoid basal cell carcinoma syn drome. How ever. a review ofthe literature revealedfive patients with this sy ndrome 11' 170 also had feta l rhabdomy omas in various locations. We report thefirstpatient with nevoid basal cell carcinotna syndrotne and afetal rhabdoiny oma ofthe tongu e. We reconunend that embryonal rhabdontyosarcoma be ni/ed out to avoid ove rly aggressive treatment ofthese patients .

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The concept of rhinogenic headaches remains a subject of much debate. While many authors have reported good results in treating these headaches with endoscopic sinus surgery, few haveattempted to establish objective criteria for identifyingthe bestsurgical candidates. Weconducted a study of 33 adults with rhinogenic headaches to determine if three elements of the history and/or five aspects of computed tomography (CT) would predict which patients might benefitfrom the minimally invasive sinus technique (MIST) as the primary treatment modality for their headaches. Postoperative follow-up interviews revealed that endoscopic surgery waswidelysuccessful, as 28 patients (84.8%) reported improvement. However, we were unable tofind any statistically significanthistoryor CT parameters that predicted surgical outcomes.

Primary Merkel cell carcinoma (MCC) is a neuroendocrine tumor that typically affects older whites. It usually originates in the dermis, but in rare instances it has arisen in other primary sites, including the oral mucosa and the parotid gland. Explanations for the presence of MCC in these atypical locations have included theories of malignant transformation and neuroendocrine migration. We describe the case of a 35-year-old white woman who had an MCC in the parotid gland and no evidence of any other primary cutaneous lesion. A left superfi cial parotidectomy with facial nerve preservation was performed, and a histologic diagnosis of MCC was made. Positron-emission tomography was negative for other lesions, and postoperative radiation therapy was administered for local control. To the best of our knowledge, this is only the sixth case of a primary MCC of the parotid gland to be reported in the English-language literature; of these 6 patients, ours was by far the youngest. Otolaryngologists should be familiar with this rare but potentially fatal neoplasm.

Thediagnosis oflow-gradeB-ceillymphoma consistent with marginal-zonelymphoma hasproven to bechallengingwhen the disease involves the hardpalate. The diagnosis is complicated by the nonspecific nature ofthe presenting symptoms and a difficult-to-different iatehistologicpicture. 1.t7e describe a caseoflow-grade B-ceillymphoma ofthe hardpalate with a delayedpresentation. 1.t7e also compare thefeatures ofthis case with thefeatures ofthe small number ofothersuch cases that have been reported in the literature. Finally, we review the etiology of low-grade B-cell lymphoma, we discuss its radiologic and pathologic features, and we briefly describe the treatmentoptions.