Giant rhinoliths are uncommon, mineralized concretions that usually develop around an intranasal foreign substance in the nasal canal. These lesions frequently cause respiratory problems, foul-smelling discharge, and nasal blockage. Clinical examination, endoscopy, and radiological imaging are used to make the diagnosis, and surgical removal is the only effective therapy. A giant rhinolith was discovered in a 42-year-old female patient with metastatic breast cancer came with nasal blockage. After 6 months, there were no complications or recurrences following the surgical removal of the calcified tumor. The significance of taking rhinoliths into account in individuals who have prolonged symptoms and unilateral nasal blockage is demonstrated by this case study. Consequently, early diagnosis and management are necessary to avoid potential complications and ensuring an excellent outcome.

Allergic fungal rhinosinusitis (AFRS) is defined as a benign, extramucosal, non-invasive fungal condition of the paranasal sinuses, resulting from a type 1 IgE-mediated hypersensitivity reaction. AFRS is most commonly seen in young adults, although it also occurs in the pediatric population. Currently, biological therapy has been proposed as an effective treatment for adult patients with AFRS. However, the use of biologics in the pediatric population has not yet been introduced in the literature. Hence, this study reports a unique case involving the use of Dupilumab to treat a pediatric patient with refractory AFRS and bronchial asthma. A 13-year-old girl with a long-standing history of bronchial asthma who was diagnosed with AFRS, started Dupilumab with a loading dose of 600 mg, followed by 300 mg biweekly. The patient showed improvement in her condition after the initiation of Dupilumab, in terms of clinical, endoscopic, and radiological outcomes. Additionally, Dupilumab was shown to be a helpful treatment in controlling the patient's bronchial asthma. In conclusion, Dupilumab appears to be a promising treatment for pediatric patients with refractory AFRS to improve their clinical, endoscopic, and radiological outcomes. However, further studies are needed in the future to validate these findings.

Primary malignant melanoma of the parotid gland (PMMPG) is an exceptionally rare neoplasm, comprising less than 0.7% of all parotid malignancies and often mistaken for metastatic melanoma. This case presents a 66-year-old man with a painless, slowly enlarging right parotid mass. Imaging revealed a lesion localized to the superficial parotid lobe with FDG (fluorodeoxyglucose)-avid level II lymph nodes. Fine-needle aspiration suggested melanoma, confirmed by immunohistochemistry. The patient underwent total parotidectomy, neck dissection, adjuvant radiotherapy and immunotherapy with pembrolizumab under ongoing oncologic surveillance. Histopathology confirmed melanoma with nodal metastasis and negative margins, with no evidence of local recurrence at 6-month follow-up. Diagnosis of PMMPG demands exclusion of other primary sites and prior excision history, making immunohistochemistry essential. Treatment typically involves surgical resection and radiotherapy; however, prognosis remains poor due to high recurrence and metastasis rates. PMMPG requires a coordinated, multidisciplinary approach. Although aggressive intervention offers the best outcomes, the long-term prognosis is limited. Continued research is essential, particularly focusing on molecular differentiation from clear cell sarcoma and the identification of specific molecular markers that can guide targeted therapy.

Chronic granulomatous invasive fungal rhinosinusitis (CGIFRS) is a type of invasive fungal rhinosinusitis that is characterized by the presence of pathologic findings of non-caseating granulomas in the paranasal sinuses. This article describes two cases of CGIFRS with fatal outcomes. The first case was for a 36-year-old man who presented with headache, dizziness, and vomiting for 1 month. This patient had received the traditional treatment, although the patient’s condition suddenly deteriorated after 1 week of surgery and died due to the disease’s complications. Similarly, the second case was for a 31-year-old man who presented with bilateral nasal obstruction and left eye proptosis for 1 year. This patient had a recurrence of CGIFRS after the first presentation, which was complicated by a cerebral abscess after 2 months of surgery. This study, therefore, underscores the severity of CGIFRS as a potentially fatal disease.

Isolated sphenoid sinus disease (ISSD) is a rare condition that accounts for roughly 3% of all sinusitis cases. ISSD is predominantly caused by infectious and inflammation processes, with underlying fungal pathologies. This case series aims to illustrate the endonasal endoscopic management of different isolated sphenoid fungal pathologies. We described four distinct case presentations of ISSD at a tertiary hospital in Dammam, Saudi Arabia. These cases included isolated sphenoid fungal ball, allergic fungal sinusitis, and acute invasive fungal sinusitis. The management of isolated sphenoid fungal pathologies differs depending on the type of the disease necessitating early identification and adequate treatment. The endonasal endoscopic approach is successful with minimal complications and favorable outcomes.

Isolated maxillary fungal pathologies involve a variety of clinical entities. These include invasive and non-invasive variants, where each has a unique pathogenesis, clinical manifestation, and approach for management. The aim of this case series is to investigate the several ways that fungal infections of the maxillary sinus might present, with the approach to diagnose and manage these conditions. Several discrete maxillary fungal diseases were studied, including fungal ball, acute fulminant invasive fungal sinusitis, allergic fungal sinusitis, and chronic invasive fungal sinusitis at a hospital. For every condition, several treatment options, clinical manifestations, and diagnostic strategies were investigated, which are greatly influenced by the degree of invasiveness as well as the patient’s immunological status. Optimizing patient outcomes, especially in more aggressive types of the disease, requires an early and proper diagnosis. Understanding the various symptoms of these fungal infections is critical for a timely management.