Spheno-occipital chordomas can rarely present as nasopharyngeal mass. Metastases occur only in advanced disease. They can pose a diagnostic dilemma when information about diagnosis of the primary tumor is not available. We present cytological findings in upper cervical lymph node of a case of nasopharyngeal chordoma and discuss possible differential in such a location.

Adrenocortical cancer is a very rare tumor with a poor prognosis. About half of them are hormone-secreting tumors. In most cases, hormonal investigations reveal an excess secretion of steroids, mostly cortisol and androgens. A 54-year-old lady presented with history of pain in left shoulder and leg for 6 months and features of virilization. CT-guided fine-needle aspiration cytology of an abdominal mass revealed the presence of a carcinoma of the left adrenal cortex. A whole-body radionuclide bone scan revealed increased uptake in the left clavicle and left femur. The patient has received palliative radiotherapy for the skeletal lesions and 3 cycles of palliative chemotherapy at present.

The aim of this article is to highlight the varied presentation and management of vallecular cysts. Three children with diagnosis of vallecular cyst presented in our department were reviewed retrospectively for clinical presentation, diagnostic tools and treatment options. All three cases presented with respiratory and feeding difficulty. Diagnosis in all the three cases was made with laryngoscopy (flexible/direct) and imaging. All three patients were treated by transoral approach aimed for excision of cyst using cold instruments. Postoperative period was uneventful and no recurrences were observed on the long-term follow up. Vallecular cysts should be considered as one of the differentials in children with respiratory distress and dysphagia in spite of being a rare anomaly. Direct transoral approach for excision of the vallecular cyst is recommended as a safe and reliable method with no recurrences till date.    Keywords: Vallecular Cyst; Respiratory Distress; Dysphagia; Laryngoscopy

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Background: India announced nationwide lockdown on March 24, 2020, to control the COVID crisis. Due to lockdown, the health care system, that is, delivery and utilization of the health facilities were adversely affected. Clinical Setting: Presentation and management of nasal foreign body cases over 3 months post COVID lockdown has been discussed. Factors for delayed diagnosis and management are assessed and compared with pre-COVID era. Result/Outcome: Due to lockdown and COVID phobia, more complicated cases of nasal foreign body are presented in post lockdown period. Conclusion: We need to formulate and standardize the management strategies to avoid such unfortunate circumstances so that even non-COVID cases are managed more appropriately and in a timely manner.