A case of spontaneous haemorrhage into the retropharyngeal and parapharyngeal space secondary to bleeding from a thyroid cyst is described. While many conditions are known to cause this entity, no previous papers have reported a thyroid cyst to cause such extensive haemorrhage. Haemorrhage in these spaces is of particular importance as it causes rapid airway compromise and can be life-threatening. Forty cases of non-traumatic retropharyngeal and parapharyngeal haematomas have been reported in the literature to date. Although the diagnosis can be easily established in most patients, no published review of this condition exists. This paper reviews all reports of non-traumatic retropharyngeal and parapharyngeal haematoma published in the literature to date and discusses management guidelines. We also present here for the first time the demographics and treatment results of this rare entity.

Calcinosis universalis is an unusual complication of systemic lupus erythematosis (SLE). We describe the case of a 22-year-old patient diagnosed with SLE during childhood, who developed a previously unreported complication of parotid calcification. Medical treatment of calcinosis is often ineffective, whereas surgical intervention completely relieved the patient’s symptoms.

Cervical necrotizing fasciitis is a rare, rapidly progressive, severe bacterial infection of the soft tissues of the neck. Uncommonly, it may descend into the mediastinum. We describe a case of descending necrotizing mediastinitis in a young man, where there was diagnostic confusion and delay, with an eventual fatal outcome. A steroid injection for neck pain is thought to be the source of infection. In this case, the signs of mediastinitis were initially masked, and the diagnosis delayed until cardiopulmonary arrest occurred. Early recognition with a low threshold for computed tomography (CT) scanning is essential. Aggressive multidisciplinary therapy with mediastinal drainage is mandatory.

The existence of a combined benign schwannoma and lymphoma presenting as a nasal polyp has not been described in the English literature. We are reporting this rare combination in a 50-year-old male whose presenting symptoms were nasal obstruction, nasal deformity and headache. Examination of the left nasal cavity revealed a mass which was confined to the nose on computed tomography (CT) scan examination. Histopathology of the mass revealed a major component to be a benign schwannoma and a minor component a large B-cell lymphoma.