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Background Patients with head and neck cancer have a higher risk of emergency department (ED) frequent attender (FA). We hypothesized that FAs present with issues different from non‐FAs. Methods A retrospective cohort study was conducted on Singapore residents with head and neck cancers using de‐identified registry merged with electronic medical record data. A competing risk regression analysis was performed to identify factors associated with FA. Aggregated primary diagnoses were compared for patients with and without FA risk factors. Results Thirteen percent of patients with head and neck cancer were FAs. FA risk factors were Charlson comorbidity index (3+), and socioeconomic status (SES). FAs had a higher proportion of respiratory infections. The spectrum of diagnosis was similar for patients with low and high SES. Current smokers had a greater proportion of respiratory complaints, relative to never smokers. Conclusion Patients with greater comorbidity scores or higher SES were more likely to be FA. FAs were more likely to present with respiratory complaints, likely related to cancer treatment, or smoking status.

Sarcomas are rare tumours, accounting for 1% of all malignancies. They are histologically diverse, presenting with more than 50 different subtypes. Sarcoma can be broadly divided into two categories-soft tissue sarcoma and bone sarcoma. Extraskeletal osteosarcoma is a unique subtype which is histologically similar to bone osteosarcoma but resides within soft tissue and has no attachments to bone. We present a rare case of a patient who initially presented with an extraskeletal osteosarcoma that was complicated by a chronic chest wall sinus and lymphedema of the left arm. He later developed enlarging left chest wall nodules at the same region that were proven to be dedifferentiated liposarcoma on biopsy 20 years later. We examine the occurrence of both extremely rare diseases of differing pathologies over the same site but separated by an extraordinarily long interval, and possible new associations to account for this phenomenon.

Background Resection of parotid carcinomas involving the parapharyngeal space is challenging. How this affects tumor margin control, recurrence, and survival is unclear. Methods Patients who underwent resection of parotid carcinomas between 1985 and 2015 at Memorial Sloan Kettering Cancer Center were evaluated for the impact of parapharyngeal extension (PPE) on margin status, local recurrence‐free probability (LRFP), and disease‐specific survival (DSS). Results Out of 214 patients in whom preoperative imaging was available for review, 22 (10.3%) had PPE. Matched by histotypes, carcinomas with PPE had comparable margin positivity (p = 0.479), T classification (p = 0.316), pathologic risk (p = 0.936), and adjuvant therapy (p = 0.617) to those without PPE. The 3‐year LRFP was 88.9% versus 95.4% (hazard ratio [HR] 2.23 after adjusting for pT classification, p = 0.342) and the 5‐year DSS was 74.2% versus 69.5% (adjusted HR 0.45, p = 0.232) in patients with and without PPE. Conclusion PPE does not appear to worsen oncologic outcomes in the resection of parotid carcinomas.