Hybrid neoplasm of the lacrimal gland, adenocarcinoma NOS with primary squamous cell carcinoma; A rare case report.

Abstract

A hybrid neoplasm is the coexistence of two histologically distinct neoplasms which arise in the same topographical area resulting in a single common mass. A seventy-one-year-old female presented with a complaint of loss of vision and pain in her right eye for a period of five months. On clinical-radiological investigations, a single ovoid,non-fluctuant, firm, tender swelling was present on the right supraorbital region with mild proptosis and redness of the right eye. Magnetic resonance imaging showed a well-defined, lobulated heterogeneously enhancing lesion on the superolateral part of the right orbit suggestive of lacrimal gland neoplasm. The specimen was submitted after wide excision with orbital exenteration and ipsilateral radical neck dissection. Histopathological evaluation revealed two different morphologic patterns of infiltrating islands of epithelial cells suggestive of an adenocarcinoma and squamous carcinoma. Histopathology with additional immunohistochemical workup concluded the lesion to be a Hybrid neoplasm of the Lacrimal gland; Adenocarcinoma NOS with Primary squamous cell carcinoma. Hybrid neoplasm of the head and neck region is found to be common in salivary glands while its occurrence in the lacrimal gland is very rare in literature.