Adenosquamous carcinoma is a rare variant of squamous cell carcinoma of the nasal septum which is very aggressive and metastasise early with poor prognosis. We present a case of a gentleman who presented with left nasal septal swelling for 4 months. Examination showed a lesion at the left nasal septum extending to the dorsum of the nose and right upper lip region. Computed tomography scan of the paranasal sinuses and neck showed an enhancing lesion with ulceration at the left nasal septum, with regional metastasis to the neck. He underwent a subtotal rhinectomy, inferior maxillectomy, and bilateral modified radical neck dissection type III. Unfortunately, he succumbed to a cardiac arrest 5 days after surgery.

Primary cutaneous anaplastic large cell lymphoma (PC-ALCL) is relatively a rare tumour of head and neck region. Without histopathological confirmation, it appears and behaved as like malignant epithelial tumor of the head and neck region as will be illustrated in the present case. Cutaneous involvement of the tumor with distant metastasis has made the prognosis unfavorable. This isolated case of head and neck PC-ALCL was highlighted as it has a tendency to behave aggressively and early diagnosis and treatment is crucial to avoid poor survival outcome.