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Intranodal schwannoma is a rare benign tumor, which originates from the peripheral nerve sheath (Schwann cells), fewer cases being reported with lymphatic involvement. We present the case of a middle-aged female patient, with one-year growing mass in the lateral-cervical area, in intimate relation with the vascular package of the neck. Preoperative cervical computed tomography examination showed the tumor features. There was no intraoperative complication, with the piece being completely removed. The morphological examination revealed the structure of a lymph node, and after Hematoxylin-Eosin staining, there were eosinophilic cytoplasm, euchromatic nuclei, with round, elongated or slightly wavy form and reduced pleomorphism, rare degenerative nuclear atypia, and no mitotic activity nor necrosis. The expression of S100 protein on immunohistochemistry, along with negative results for smooth muscle actin and desmin sustained the diagnosis of intranodal schwannoma of the neck. With a low index of cellular proliferation (Ki67), this case is in line with the reported features of schwannoma having extremely rare malignant transformation.

Chondrosarcomas of the larynx are rare cancers, representing less than 1% of all laryngeal tumors. The most often involved site is the cricoid cartilage. They have generally good prognosis, and low metastatic tendency. Surgery is the treatment of choice, partial in small limited tumors or total laryngectomy if tumor extends beyond the half of the cricoid and/or is poor differentiated. Although there are some pathognomonic imaging characteristics for chondrosarcomas, the histology remains the gold standard for diagnostic. The authors present a case of large, medium differentiated chondrosarcoma (grade II), surgically treated by total laryngectomy.

Introduction. The primitive malignant melanoma of nasal mucosa and paranasal sinus is a rare tumor of uncertain etiology, with unpredictable biologic behavior and bad prognosis. Unlike skin melanomas, there are no risk factors and the disease is frequently manifested in older patients, whose clinical otorhinolaryngology complaints are normally non-specific and ranges from nasal obstruction to rhinorrhea and epistaxis. Unfortunately, this disease is diagnosed basically in advanced stages which makes the surgery difficult. Objective. To report a case of primitive malignant melanoma of nasal mucosa, ethmoid and frontal sinuses, that was diagnosed in 2015. It was performed a subtotal resection in another hospital in 24.08.2015, with a large local reccurence. Report. Our patient was a 78-year-old woman with bilateral nasal obstruction, light epistaxis and unilateral rhinorrhea. The ENT, CT and MRI exams showed a tumour with important, invasion of the nasal cavity structures (billateral nasal bones, left frontal process of the maxilla, the superior midpoint of the nasal septum, bilateral middle and superior turbinates, left ethmoid and bilateral frontal sinuses). The patient was submited for surgery: total macroscopic resection in the combined endoscopic approach; transnasal and modified lateral rhinotomy with titaniul plates reconstruction of the external nose architecture. Conclusions. Malignant melanomas of nasal mucosa are, in general, diagnosed in advanced stages. Their histological characteristics in the mucosa makes difficult the surgical treatment, which is one of the most efficient options, because they are resistant to chemo and radiotherapy. The early diagnosis and a good surgical treatment plan are the best option for this tumor nowadays.

The extranodal malignant lymphomas occur mainly in the region of the head and neck, after the gastrointestinal tract. The most common site of the head and neck lymphoma is at the lymphatics ring of Waldeyer, followed by the nasosinusal region. Localization at the base of the tongue is extremely rare. The authors reported a case of a 50-year-old male with a non-Hodgkin's lymphoma, which developed at the base of tongue. An unusual sensation described as a foreign body at the hypopharyngeal region associated with progressive dysphagia were the main symptoms for which the patient was referred to our Hospital. The fibroscopic exam has revealed an oval tumor of the base of tongue, with large dimensions, sessile emergent base and smooth superficial mucosa. The tumor was removed using an endoscopic transoral approach, followed by the histopathological and immunohistochemical examination, which have been suggestive for non-Hodgkin's lymphoma with small B-cells. The treatment continued with chemotherapy, while radiotherapy was not necessary due to the fact that the tumor was completely removed.

Background. Extraskeletal Ewing’s sarcoma is a rare tumor of mesenchymal origin, which is histologically similar to primary osseous Ewing’s sarcoma. It has been reported a low incidence in the head and neck. Methods. We report the case of a patient with extraskeletal Ewing’s sarcoma presenting with a lateral and posterior left sided neck mass. Magnetic resonance imaging was useful in preoperative evaluation. The treatment consisted in radical resection, and the histological analysis completed the diagnosis. Results. The postoperative management consisted in a combination of chemotherapy for systemic control and irradiation for local control. PET-CT was useful to evaluate the treatment’s efficacy. Conclusions. Extraskeletal Ewing’s sarcoma is a rare and aggressive tumor. A very few cases of cervical tumors were reported. Radical resection followed by radio-chemotherapy has good results in the treatment of this rare tumor.

Although the administration of hydrocortisone in septic shock generates adverse effects, the risk of corticosteroid-induced hypernatremia may be reduced by continuous administration of the drug [1][2].