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EAST AVENUE MEDICAL CENTER<br />
DEPARTMENT OF OTOLARYNGOLOGY<br />
TITLE • CollisionTumor of the Nasopharynx(Liposarcoma,<br />
UndifferentiatedCa) Reportof a Case<br />
AUTHORS:GeraldS. Chua,M.D.<br />
AngelV. Veloria,M.D.<br />
Mamerto(3.Almelor, M.D.<br />
Milagros S. Lopez,M.D. ..<br />
INTRODUCTION health center which provided temporary relief. The<br />
patient consulted at EAMC because of the persistence<br />
We report a case of a rare, highly malignant collision of epistaxis and was subsequently admitted, He has<br />
tumor. A liposarcoma of the nasal cavity with extension a 35 pack year smoking history and has been taking<br />
to the ethmoid and orbit and an undifferentiated Ca alcoholic drinks for 30 years, In the past three months<br />
of the nasopharynx. Biopsy was done three times from he lost 35 pounds.<br />
the nasal mass and nasopharynx. Radical maxillectomy<br />
with orbital exenteration, radical neck dissection On admission, the significant findings were:<br />
and post-op radiation was contemplated. Unfortunately, retracted TM, AD, a grayish-reddish gelatinous friable<br />
the patient deteriorated until his untimely demise before mass about .5 cm at the area of the middle (R) turbinate,<br />
the proposed management was instituted, a 1 cm fleshy mass at the area of the posterior choanae,<br />
bilateral infra-auricular neck nodes both measuring 2<br />
x 3 cm. PNS x-ray reveals bilateral maxillary sinusitis.<br />
OBJECTIVES Except for minimal PTB other laboratory work-ups<br />
were unremarkable. The admitting impression was<br />
1, To report a rare collision tumor involving NPCA, stage III.<br />
liposarcoma of the nasal cavity, paranasal<br />
sinuses and orbit and an undifferentiated Ca The first biopsy of the nasal mass revealed<br />
of the nasopharynx, liposarcoma. However, a repeat biopsy of the nasopharynx<br />
was suggested. The repeat biopsy was<br />
2. To review the literature regarding liposarcoma undifferentiate Ca. After a week, a third biopsy was<br />
of the head and neck. done as per suggestion of the pathologist. The previous<br />
' diagnosis was confirmed - Liposarcoma, myxoid type<br />
3. To present a local retrospective study on with some degree ofdifferentiadon at the nasal cavity<br />
liposarcoma of the head and neck. with an undifferentiated Ca of the nasopharynx, a<br />
collision tumor.<br />
CASE REPORT He was scheduled for radical maxillectomy (R)<br />
with possible orbital exenteration and RND (R) pend-<br />
A 49-year old taxi driver was admitted for the first ing C-T scan results, However, he developed proptime<br />
at the East Avenue Medical Center for recurrent tosis, lid edema, lateral and medial rectus palsy, OD<br />
epistaxis from the right nose, The patient had cough and hypoesthesia of the right half of the face. C-T scan<br />
and colds with yellowish, mucoid, blood-tinged spu- showed a mass in the right half of the nasal cavity<br />
turn, 7 months VIA which were temporarily relieved displacing the nasal septum to the left, with lyric changes<br />
by self-prescribed medications. One month PTA, he in the medial wall of the right maxillary sinus with<br />
noted decrease in hearing acuity (R) and (R) nasa] extension of the mass to the sella, ethmoid and spheobstruction.<br />
The epistaxis increased in frequency and noid sinuses. There is also involvement of the (R)<br />
amount. He was given hematinics IM at the local medial rectus muscle and the orbital roof. Two days<br />
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