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We report the clinical case of a 57 years-old female with Multi- nodular Goiter (BMN) grade IV-V and giant that had produced a bilateral recurrential palsy by compression and a near total glotic stenosis. The acute dyspnea of the patient required a tracheostomy and later we performed a total thyroidectomy with AP diagnosis of nodular hyperplasia. There were not complications after the surgery.The giant goiters can a!fect the airway seriously. Symptoms and imaging tests are usefull for diagnosis and the first treatment is surgery in these cases.

The hypereosinophilic síndrome is a multisystem pathology characterized by peripheral blood eosinophilia and affectation of di!ferent organs like the heart, lung, skin and C.N.S. At E.N.T. level it can produce rhinitis, oral mucosal ulcerations (aphthas), angioedema and sialorrhea that are not criteria for the diagnosis of this illness.We report the clinical case of a 64 years old male who su!fered pulmonary, cutaneous and medullar involvement. He was treated by chemotherapy and corticotherapy with good response and complete remission actually. We must suspect such a syndrome in recurrent mucosal ulcerations together or not with sialorrhea. The collaboration of Internal Medicine Service in the management of these patients is of utmost importance.

The coexistence of primary hyperparathyroidism and sarcoidosis is very uncommon in the literature being still unknown the mechanism of such association. A case of a 37 year-old male is reported who presented hypercalcemia that was not corrected with a steroid test. Besides his pulmonary illness a parathyroid lower left adenoma was also detected. After removal of the adenoma, the calcium and para thormon (PTH) levels were normalised with a good clinical evolution. A literature review respecting this association is presented.