Microscopic polyangiitis (MPA) is a primary systemic vasculitis characterized by inflammation of small-sized vessels associated with the presence of anti-neutrophilic cytoplasmic antibodies. We report a case of a 39-year-old female diagnosed with microscopic polyangiitis as an incidental finding who presented with signs and symptoms of a stroke at a young age. Usually, it presents with fever, malaise, skin rash, weight loss, mononeuritis multiplex, and arthralgia/myalgia. Very rarely, it can involve meninges to cause meningeal vasculitis which can present as a febrile seizure. The most frequent neurological manifestation is peripheral neuropathy. Cerebral infarction or hemorrhage as an isolated finding is very rarely observed in the patient with MPA as was seen in our patient.

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Nasopharyngeal rhabdomyosarcoma is a rare tumour of the paediatric age group that emerges from embryonal mesenchymal cells. Presented here is a case of a 54-year-old male of Asian ethnicity with a notable history of weight loss, lack of energy, anal fissure, and haematochezia. After the incidental finding of a lytic lesion following imaging, the patient underwent an extensive work-up to rule out malignancy and increased uptake on nasopharynx was found, which was biopsied to diagnose a poorly differentiated tumour, having desmin and myogenin positivity on immunohistochemistry. Metastatic work-up showed extensive bone marrow invasion apart from multiple lytic bone lesions throughout the body. The patient was started on vincristine, actinomycin D (dactinomycin), and cyclophosphamide (VAC) protocol chemotherapy and was followed-up until two cycles were completed, with no evidence of disease remission.