More than meets the eye

BMJ Case Rep. 2019 Feb 7;12(2):e212000. doi: 10.1136/bcr-2015-212000.

Abstract

We report an extremely rare case of a hybrid tumour of the maxillary sinus. A 51-year-old man presented with a 6-week history of nasal congestion and epiphora. Radiological imaging demonstrated a maxillary sinus tumour, with extensive local invasion. Surgical excision included maxillectomy, left eye exenteration and free flap closure. Histology of the excised specimen showed a rare hybrid tumour containing adenoid cystic carcinoma, salivary duct carcinoma, epithelial-myoepithelial carcinoma and basal cell adenoma. Hybrid tumours are very rare tumour entities which are composed of at least two distinct tumour types. Each tumour entity conforms with a defined tumour type. The tumour entities of a hybrid tumour are not separated but have an identical origin within a definite topographical area. Diagnosis and appropriate management requires high index of suspicion, pathological endeavour to look for a more aggressive accompanying tumour and adequate oncological treatment according to the highest grade of tumour.

Keywords: ear, nose and throat/otolaryngology; head and neck cancer; pathology.

Publication types

  • Case Reports

MeSH terms

  • Carcinoma, Adenoid Cystic / diagnostic imaging
  • Carcinoma, Adenoid Cystic / pathology*
  • Carcinoma, Adenoid Cystic / therapy
  • Ethmoid Bone / pathology
  • Ethmoid Bone / surgery
  • Humans
  • Lacrimal Duct Obstruction / diagnostic imaging
  • Magnetic Resonance Imaging*
  • Male
  • Maxillary Sinus Neoplasms / diagnostic imaging
  • Maxillary Sinus Neoplasms / pathology*
  • Maxillary Sinus Neoplasms / therapy
  • Middle Aged
  • Nasal Obstruction / diagnostic imaging
  • Neoplasms, Multiple Primary / diagnostic imaging
  • Neoplasms, Multiple Primary / pathology*
  • Neoplasms, Multiple Primary / therapy
  • Orbital Neoplasms / diagnostic imaging
  • Orbital Neoplasms / pathology*
  • Orbital Neoplasms / therapy
  • Orthognathic Surgical Procedures
  • Paranasal Sinuses / pathology*
  • Plastic Surgery Procedures / methods
  • Radiotherapy, Adjuvant
  • Salivary Gland Neoplasms / diagnostic imaging
  • Salivary Gland Neoplasms / pathology*
  • Salivary Gland Neoplasms / therapy
  • Treatment Outcome