Sinonasal Teratocarcinosarcoma of the Head and Neck (original) (raw)
Related papers
2019
Introduction: Sinonasal teratocarcinosarcoma (SNTCS) is an uncommon and very aggressive tumor that often involves the anterior skull base. The histopathologic findings of this neoplasm comprise a highly complex malignant tumor with combined features of carcinosarcoma and teratoma. Case Presentation: A 34-year-old woman with SNTCS of the nasopharynx who had endoscopically operated twice (36 and 18 months ago) and received 33 fractions (66 Gy) of radiotherapy after the second operation, developed left neck metastasis about nine and half month after the second operation. Functional neck dissection was performed for her about twelve months later. The patient received 27 fractions (54 Gy) of radiotherapy again. She had been well during her follow-ups. Conclusion: According to the medical literature, patients who were treated with surgery and adjuvant chemoradiation showed lower recurrence and better survival rate than those who were treated with surgery and radiotherapy, however, the nu...
Sinonasal teratocarcinosarcoma: a clinicopathologic and immunohistochemical study of 6 cases
Annals of Diagnostic Pathology, 2013
Keywords: Nasal cavity Teratocarcinosarcoma Chemoradiation Lung Dura Metastasis Teratocarcinosarcoma (TCS) is a rare and unusual malignant neoplasm of the sinonasal tract with a heterogenous morphology and an aggressive behavior. Patients are predominantly adults with a male predominance. The aim of this study was to describe clinicopathologic and immunohistochemical features of 6 cases of TCS. The ages ranged from 18 to 67 years (mean, 33 years) with a male-to-female ratio of 5:1. Most tumors were located in the nasal cavity. Nasal obstruction and epistaxis were the common presenting symptoms. Histologically, all tumors exhibited a heterogeneous morphology with varying proportions of benign and malignant epithelial, mesenchymal, and neuroepithelial elements. Adenocarcinoma was the malignant epithelial component in all cases. The mesenchymal elements were composed of benign to malignant spindle cells. Osteosarcomatous areas were seen in 2 cases and rhabdomyosarcoma in 1 case. Rhabdoid differentiation was also seen in 1 case. Immunohistochemical stains CKAE1/AE3 and CK Cam 5.2 were positive in the epithelial elements, vimentin in mesenchymal, and CD56 and neuron-specific enolase in neuroepithelial elements. Follow-up was available in 4 patients and ranged from 21 to 40 months (mean, 31 months). Lung and dura metastasis, respectively, were seen in 1 patient each. However, all 4 patients are alive and free of disease to date. In conclusion, TCS is a rare but highly malignant tumor with aggressive behavior characterized by benign and malignant epithelial, mesenchymal, and neuroepithelial components. Two patients in our series were younger than 20 years. The occurrence of rhabdoid differentiation and osteosarcomatous component seen in our series were rarely described in literature. Recognition of all the components requires adequate sampling, which is crucial for a correct diagnosis.
Sinonasal teratocarcinosarcoma with intracranial extension: case report and literature review
Sinonasal teratocarcinosarcoma (SNTCS) is an extremely rare malignancy of the paranasal sinuses that possesses the histopathologic features of both teratomas and carcinosarcomas. We report the case of a 58-year-old white man who presented with a 1-year history of a gradually enlarging left-sided nasal mass. The patient had previously undergone endoscopic sinus surgery at another facility, and the final pathologic specimen was reported as an SNTCS with positive margins. He was then referred to our institution, where he underwent a craniofacial resection combined with endoscopic intranasal resection. Postoperatively, he received combined chemotherapy and irradiation. At 48 months of follow-up, he was alive without evidence of disease.
Pathologica, 2021
Sinonasal teratocarcinosarcoma is a rare aggressive malignant tumor with a primary setting involving the nasal cavity followed by the ethmoid sinus and maxillary sinus. It accounts for approximately 3% of all head and neck cancers and less than 1% of all tumors. Nasal obstruction, recurrent epistaxis and headache represent the typical clinical presentation. Imaging shows the presence of a mass in the nasal cavity. The treatment usually consists of surgery and adjuvant intensity modulated radiotherapy. The rarity and the variability of the histological features make its diagnosis particularly difficult. In this paper, we report a case of sinonasal teratocarcinosarcoma in a 62-year-old male treated with a multidisciplinary approach. As an alternative to intensity modulated radiotherapy, we proposed proton beam therapy for the first time. The patient benefited from the new and personalized protocol that provided excellent results and few adverse effects. At 45 months follow-up there is no evidence of relapse and the patient is in good health.
Teratocarcinosarcoma of the Nasal and Maxillary Sinus Mass- a Rare Case
Journal of Evolution of Medical and Dental Sciences, 2019
A 42-yr. old man presented with chief complaints of nasal blockage, nasal bleeding and later on pain in the eyes and headache and progress to nasal mass within period of 3 months. Routine haematological and biochemical investigations were done, which were normal at the time of presentation. Nasal endoscopy was done which showed nasal mass which bleeds on touch. A computed tomography (CT) scan face and neck revealed an inhomogenously enhancing soft tissue density lesion measuring 5.7*3.3*3.9 cm involving left maxillary sinus extending to left ethmoid sinus, left nasal cavity reaching up to posterior choana abutting the nasal septum (Figure 1).
An International Journal of Otorhinolaryngology Clinics
Sinonasal teratocarcinosarcoma (SNTCS) is a rare, highly malignant tumor arising from primitive embryonic sinonasal tissue or immature pluripotential cells occurring almost exclusively in the sinonasal tract. It is an aggressive tumor with a high propensity for locoregional recurrence and mortality. Local recurrence of SNTCS after excision has been reported as high as 45% with a mean recurrence time of 21.3 months. Even though distant metastasis is rare, local recurrence frequently leads to treatment failure and subsequent death. In view of its aggressive behavior, radical excision with or without chemoradiation is advocated as the optimum treatment. Here we share our experience of SNTCS in a 23-year-old man managed with endoscope assisted craniofacial resection followed by histocytology-directed chemotherapy with external beam radiation. He remains disease-free in the last 3 years of follow-up.
Pharyngeal teratocarcinosarcoma: review of the literature and report of two cases
Annals of Diagnostic Pathology, 2006
Teratocarcinosarcomas are rare malignant neoplasms histologically characterized by the presence of benign and malignant epithelial and mesenchymal elements. They are seen almost exclusively in the sinonasal tract of men. We report two cases of teratocarcinosarcomas involving the posterior pharyngeal wall in a 55-year-old male and 60-year-old men. The tumors consisted of epithelial components including squamous, neuroendocrine, and glandular structures; neuroepithelium, and mesenchymal components with prominent rhabdomyoblastic, osteoblastic and chondroid differentiation. Immunohistochemical studies demonstrated markers characteristic of each component. The tumors were resected, and the patients received postoperative radiation therapy. One patient is alive with recurrent tumor 33 months after treatment and the other died 26 months after radiation therapy with distant metastasis. D
Clinicopathological study of sinonasal malignancy
Bangladesh Journal of Otorhinolaryngology, 2010
This cross sectional study was done in the . In this study 30 patients of sinonasal malignancy were studied and to observe the clinicopathological pattern of sinonasal malignancy. The diagnosis was made by detailed history, clinical, radiological and histopathological examinations. In this study majority of the patients were within 40 to 70 years of age (77%). Male to female ratio was 2.33:1. Majority of the malignancy came from maxillary sinuses 15(50.00%); ethmoidal sinuses were involved in 8(26.66%) cases, multiple sinuses were involved in 5(16.66%). Neck node metastases was found in 4(14%) cases. Squamous cell carcinoma was the most common histological type (70.00%); the other less common histological types were adenoid cystic carcinoma (06.66%), adenocarcinoma (06.66%), Non-Hodgkin's lymphoma (06.66%), least frequent types were malignant fibrous histocytoma, transitional cell carcinoma, olfactory neuroblastoma.