Teratocarcinosarcoma of the nasal cavity Report of a case showing favorable prognosis

Abstract

We report a very rare case of teratocarcinosarcoma of the nasal cavity showing a favorable prognosis. The patient was a 66-year-old man with a mass completely obstructing the right nasal cavity. Subsequently, extirpation of the mass and Denker-Watsuji operation were performed, and the patient was treated with a combination of radiation therapy and chemotherapy. Neither recurrence nor distant metastasis was observed during follow-up lasting 30 months. Histologic examination of the resected mass revealed several tissue elements including columnar and squamous epithelia with atypia, smooth muscle cells with rare mitotic activity, and neuroectodermal tissue. The glandular epithelium and smooth muscle cells were reminiscent of a primitive intestinal organoid structure, suggestive of teratomatous tumorigenesis. Our case and a review of the literature indicate that the absence of invasiveness to the stroma or surrounding tissue is closely related to a favorable prognosis.

Sinonasal Teratocarcinosarcoma

“…9 Accurate estimation of survival outcome, however, will not be conclusive until sufficient cases have been reported. 8 With the rarity of this tumor, such knowledge may require some patience.…”

Sinonasal Teratocarcinosarcoma of the Head and Neck

“…[5][6][7][8][9][10][11][12][13][14] This wide variation is largely related to the nature of the publications: single case reports and consultative series. [5][6][7][8][9][10][11][12][13][14] This wide variation is largely related to the nature of the publications: single case reports and consultative series.…”

Sinonasal Teratocarcinosarcoma: A Rare Clinical Entity managed by Medial Maxillectomy and Adjuvant Chemoradiation

“…3,[9][10][11][12] These tumors arising in the sinonasal tract has an insidious course and becomes symptomatic only after invading surrounding tissues in advanced stages making the overall prognosis poor. 3 As the literature review about the tumor is limited and management protocols are not defined a multimodality treatment including surgery, radiation and chemotherapy appears an optimal approach.…”

“…3 Most of the literature reported a 89% incidence in males and 11% in females. [2][3][4][5][6][7][8][9][10][11][12][13][14][15] The rapid growth and extensive local destruction hinders early diagnosis. Diagnosis is made by the presence of immature neural tissue and fetal epithelial structure admixed with various malignant and mesenchymal elements.…”

“…Diagnosis is made by the presence of immature neural tissue and fetal epithelial structure admixed with various malignant and mesenchymal elements. 3,[11][12][13][14][21][22][23][24] An origin from a primitive neural crest or stem or progenitor cell with multidirectional differentiation is currently favored. 14,20,24 Local recurrence after surgery was seen in 30 to 43%, hence, adjuvant treatment is recommended in the form of radiation and chemotherapy.…”