A Case Report of Sinonasal Teratocarcinosarcoma

Abstract

A sinonasal teratocarcinosarcoma (SNTCS) is a rare and aggressive malignant neoplasm histologically characterized by the combination of one or more epithelial elements and mesenchymal components. We report a case of a 78-year-old man with SNTCS involving the nasal cavity and paranasal sinuses. He complained of epiphora and exophthalmos with weight loss. Physical and diagnostic images resulted T4N0M0. The tumor was completely and widely resected via a trans-facial approach to perform total maxillectomy with orbital exenteration. The clinical presentation, pathologic features, and clinical course are described with a review of the literature.

Sinonasal Teratocarcinosarcoma of the Head and Neck

“…Of the 9 patients who underwent postoperative radiotherapy, information on the dose and the rate of radiation administered was available for 7 patients. 3,14,25 Most of the tumors in our series, as in previous reports, showed extension to adjacent structures at the time of presentation, with the nasal cavity and/or the paranasal sinuses being the most frequently affected. Radiation therapy was directed to the primary site only, and no patient received elective nodal irradiation.…”

Intensity-modulated radiotherapy for sinonasal teratocarcinosarcoma

“…The most common symptoms are nasal obstruction with or without epistaxis. Other manifestations includes headaches, dizziness, somnolence, apathy, and nausea and they are usually related to the degree of tumor extension [3,15,16] . Radiological result reveals nonspecific features, depending on the location of the lesion.…”

Sinonasal Teratocarcinosarcoma

“…SNTCS, by its terminology, exhibits both teratoid and carcinosarcomatous characteristics: the histologic presentation consists of a variegated pattern of epithelial and mesenchymal elements. 3 In as much the tumor exhibits high degree of histologic heterogeneity, proper tissue availability is essential for examination. Small biopsy and/or inadequate sampling may not show the complete spectrum of histologic patterns.…”

“…Current figures show that combination surgery/radiotherapy provides a 50% 5-year survival rate, just slightly better than surgery alone (47%). 3 Few patients have been treated with chemotherapy (approximately 15%). Sharma et al have reported effective control of tumor recurrence under control (for a short period) with adjuvant chemotherapy.…”