Sinonasal teratocarcinosarcoma with intracranial extension: case report and literature review (original) (raw)
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Sinonasal Undifferentiated Carcinoma with Intracranial Extension
Skull Base, 2006
Aim: To report our experience in the management of sinonasal undifferentiated carcinoma (SNUC) over a period of 15 years. Study design: A retrospective case review of 13 patients with SNUC treated at the University of California, Davis, Medical Center (UCDMC) Center for Skull Base Surgery, over the past 15 years. Results: Most tumors arose in the ethmoid sinuses. All but 1 patient had a combined intracranial-extracranial resection through the anterior fossa-transcranial route and postoperative irradiation. The 13th patient had a transfacial subcranial approach. There are 6 who have survived free of disease at 14 years' to 8 months' follow-up. The average follow-up was 6 years, 3 months. One patient died of a pulmonary embolism in the first postoperative week, a second died of a bowel infarction 3 months postoperatively. Three patients died of their disease at 20, 18, and 8 months postoperatively: 1 with local recurrence and distant metastasis and the other 2 with local control but distant disease. The 6 survivors are at 8, 20, 28, 62, 84, and 105 months. Conclusion: SNUC is a rare malignancy of the paranasal sinuses with a poor prognosis. Radical surgery and adjunctive therapy can achieve good survival in a significant proportion of patients who would hitherto have seemed incurable.
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).
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 of the Head and Neck
Archives of Otolaryngology–Head & Neck Surgery, 2008
To present the clinicopathologic features of 10 sinonasal teratocarcinosarcomas managed at a single center. Teratocarcinosarcoma is a rare morphologically heterogeneous and highly malignant neoplasm. Previous reports of these tumors have focused on their differential diagnosis and histogenesis and consisted of individual case reports and consultation based series. Design: Review of patient medical records and microscopic slides of all tumor tissues. The histopathologic features for each tumor and the demographic, clinical, treatment, and follow-up information were recorded for each patient. Also, a comparison with previously reported series was performed.
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.
A rare case report of sinonasal undifferentiated carcinoma of paranasal sinuses
International Journal of Otorhinolaryngology and Head and Neck Surgery, 2020
Sino nasal malignancies account for only 0.2-0.8% of all malignancies and undifferentiated carcinoma is rare malignant tumour of sinonasal tract, with extremely poor prognosis. We report a case of sinonasal undifferentiated carcinoma which we managed by surgery followed by post-operative radiotherapy with concomitant platinum-based chemotherapy. Although the overall survival is about 20% at 5 years and there are frequent recurrences combined modality treatment is the best management option available at present.
Carcinosarcoma: a rare sinonasal malignancy with atypical behaviour
International Journal of Otorhinolaryngology and Head and Neck Surgery
Carcinosarcoma is an extremely rare neoplasm in the nasal cavity and in the paranasal sinus, with rapid growth and extensive local destruction. We report a case of a 61-year-old man with progressive left-side nasal obstruction and epiphora for six months. Imaging showed a massive mass lesion, mainly located in the left nasal cavity and ethmoid sinus, with no intracranial or orbital extension. Biopsy of the nasal mass revealed a poorly-differentiated squamous cell carcinoma associated with sarcomatous elements. Patient underwent an endoscopic transnasal resection. Definitive histopathologic analysis revealed a carcinosarcoma. Postoperative radiotherapy was, then, performed. After five years of follow-up, there is no evidence of tumor recurrence. This report highlights that even though despite the lack of optimal treatment protocol, long term disease control can be achieved through endoscopic transnasal resection complemented with radiotherapy.
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.
Undifferentiated Sinonasal Carcinoma-Case Report
Journal of Pharmacy and Pharmacology 7 (2017) 434-438, 2017
SNUC (undifferentiated sinonasal carcinoma) is a rare tumor. The exact cause of this cancer is not known. Patients usually have signs and symptoms of bleeding from the nose, runny nose, duplicate photos, symptoms of chronic sinus infections and nose, nasal obstruction, or facial pain. We reported a case of seventy year old patient with sinonasal undifferentiated carcinoma in the right maxillary sinus. Six months ago, the patient was conducted operations polyp in the right nasal hall. He had pain in the right side of his face and swelling in the mouth in the area of the upper jaw on the right side. The patient was operated tumor of the right maxillary sinus, with expansion in the ethmoid sinus, nasal cavity and infratemporal space. The neck dissection was done on the same side. Postoperatively, he received radiation therapy and chemotherapy. SNUC is very rare aggressive cancer that requires aggressive therapy. This cancer is considered in need of modified maxillary sinuses, as well as for modified sinus in polyps or after the operation of the same. Despite extensive surgery, radio therapy and implemented chemotherapy, the prognosis of these tumors is very poor.