Giselle L Gotamco
University of Santo Tomas Hospital
Giselle L Gotamco, MD, has completed her medical education at University of Santo Tomas. She spent her Post-graduate internship at the Chinese General Hospital and Medical Center. She is currently on her first year of residency training in Otorhinolaryngology – Head and Neck Surgery at the University of Santo Tomas Hospital.
Hybrid neoplasm is a rare tumor composed of two different tumor entities, each with an exactly defined tumor category and arising from an identical origin within the same area, producing a single mass. It should be distinguished from tumors with more than one growth pattern. Less than 30 cases have been described and represent less than 0.1-0.4% of all registered tumors in the salivary glands. Occurrences in the salivary glands, palate, maxillary sinus, larynx, and lacrimal gland have been reported. There have been no published reports of an intranasal hybrid carcinoma. This is a case report of a 62-year old male presenting with nasal obstruction in a Tertiary Private Hospital. The patient had a 30-year history of nasal obstruction accompanied by a progressively enlarging mass on the nasal bridge, pain, anosmia, and epistaxis. Endoscopy showed flaring of the septum antero-superiorly with intact mucosa. MRI showed ill-defined lytic bone lesions with solid mass component involving nasal bones, hard palate, and alveolar process and a right nasal polypoid nodule. Biopsy showed undifferentiated carcinoma, prompting nasal bone and septum excision through a lateral rhinotomy incision. Histopathology revealed a hybrid tumor composed of adenoid cystic and squamous cell carcinoma, moderately differentiated. The patient underwent 13 cycles of radiation therapy. Hybrid tumors are rare tumor entities. It is important to recognize both components and distinguish the higher histologic type in determining its aggressiveness and in formulating treatment options and prognosis. Diagnosed patients require close and extended follow up and monitoring.