Imatinib therapy has been successful in gastrointestinal stromal tumours containing mutation of the KIT gene. However, there are few reported cases of successful imatinib therapy in patients with melanoma containing KIT gene mutation or c-kit protein expression.

A 52-year-old man developed metastatic melanoma from a primary melanoma in the left side of the nasopharynx. The tumour was positive for c-kit protein, and there was a KIT mutation in exon 11. He was treated with imatinib. A follow-up scan one year later showed a complete response. Treatment targeting the biological characteristics of melanoma proved successful in this patient.

Cervical sparganosis is a rare condition that presents as a lateral neck mass. Its radiological findings have not previously been investigated. Thus, the important radiological findings of cervical sparganosis are presented herein.

We report two patients with cervical sparganosis who presented with cervical masses, and we review the relevant head and neck literature. Computed tomography was performed three times over 13 months of follow up for one patient.

On follow-up radiological examination, a migratory lesion with a tubular appearance, seen on serial images, should be considered significant for cervical sparganosis.

Radiologically, a migratory cervical mass in the head and neck area with a tubular appearance is suggestive of cervical sparganosis.

We report an extremely rare case of an aberrant internal carotid artery in the middle ear, together with a dehiscent high jugular bulb, a combination never previously reported.

Case report with a review of the literature.

A 24-year-old man presented with a five-year history of aural fullness, pulsatile tinnitus and mild hearing impairment in his right ear. Otoscopy revealed a retro-tympanic mass. Computed tomography of the temporal bone revealed protrusion of the right internal carotid artery into the middle-ear cavity, with a dehiscent high jugular bulb. Magnetic resonance angiography showed a reduced diameter and lateralisation of the right internal carotid artery. A diagnosis of an aberrant internal carotid artery with a dehiscent high jugular bulb was made, and the patient was managed with conservative treatment.

The otologist should be aware of the possibility of an aberrant internal carotid artery when the patient presents with a retro-tympanic mass, hearing loss and pulsatile tinnitus. Radiological investigation is required to make the differential diagnosis. When an aberrant internal carotid artery presents with a dehiscent high jugular bulb, the risk of serious bleeding is elevated. We recommend a conservative approach for cases presenting without bleeding complications.

We present a case of bilateral chylothorax, a rare but life-threatening complication, which developed following a left-sided neck dissection.

Case report and literature review.

Chylous leakage fistula is a known complication following neck dissection and occurs in 1 to 2 per cent of patients. After left-sided neck dissection, chylothorax is uncommon and bilateral chylothorax is even rarer. Chylothorax is encountered following certain thoracic procedures, especially superior mediastinal dissection for thyroid cancer treatment. We discuss in detail the successful management of a complicated case.

We discuss various management options for this condition, and we summarise its successful management within our department.