Sinonasal teratocarcinosarcoma treated with surgery and proton beam therapy: clinical, histological aspects and differential diagnosis of a new case (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 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 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.
A Multi-Institutional Experience of Proton Beam Therapy for Sinonasal Tumors
Advances in Radiation Oncology, 2019
To report the outcomes of sinonasal tumors treated with proton beam therapy (PBT) on the Proton Collaborative Group registry study. Methods and Materials: Sixty-nine patients with sinonasal tumors underwent curative intent PBT between 2010 and 2016. Patients who received de novo irradiation (42 patients) were analyzed separately from those who received reirradiation (27 patients) (re-RT). Median age was 53.1 years (range, 15.7-82.1; de novo) and 57.4 years (range, 31.3-88.0; re-RT). The most common histology was squamous cell carcinoma in both groups. Median PBT dose was 58.5 Gy (RBE) (range, 12-78.3; de novo) and 60.0 Gy (RBE) (range 18.2-72.3; re-RT), and median dose per fraction was 2.0 Gy (RBE) for both cohorts. Survival estimates for patients who received de novo irradiation and those who received re-RT were calculated using the Kaplan-Meier method. Results: Median follow-up for surviving patients was 26.4 months (range, 3.5-220.5). The 3-year overall survival (OS), freedom from distant metastasis, freedom from disease progression, and freedom Preliminary data were presented at Particle Therapy CoOperative Group (PTCOG) 56 in Japan. Sources of support: No funding was received for this study.
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.
The Role of Radiation Therapy in the Management of Sinonasal and Ventral Skull Base Malignancies
Otolaryngologic clinics of North America, 2017
Sinonasal and ventral skull base malignancies are rare tumors that arise in a complex anatomic location juxtaposed with critically important normal tissues. The standard treatment paradigm for most histologies has been surgery followed by postoperative radiation therapy. Because of their propensity to present at an advanced stage and the presence of nearby critical structures, patients are at risk for severe radiation-induced long-term toxicity. Recent advances in radiotherapy technique have improved the therapeutic ratio between tumor control and normal tissue toxicity. This article reviews issues pertinent to the use of radiotherapy in the management of these tumors.
An International Journal Otorhinolaryngology Clinics
Sinonasal teratocarcinosarcoma (SNTCS) is a rare, highly malignant tumor arising from the primitive embryonic sinonasal tissue or immature pluripotent cells occurring almost exclusively in the sinonasal tract. It is an aggressive tumor with 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 male managed with endoscope-assisted craniofacial resection followed by histocytology-directed chemotherapy with external beam radiation. He remains disease-free in last 3 years of follow-up.
Sinonasal neoplasms: A tertiar center experience
Journal of Experimental & Clinical Medicine, 2021
Primary tumors of the nasal cavity can be classified as benign or malignant. Patients with tumors of the nose and paranasal sinuses are usually diagnosed in the advanced stages of the disease. The aim of this study was to evaluate the data of patients who were operated for sinonasal masses in our clinic in light of the literature. Between January 2016 and December 2018, 357 cases of sinonasal masses presenting to the Otorhinolaryngology Department of the Health Science University at the Samsun Training and Research Hospital were retrospectively screened and included in the study. Of the 357 patients included in the study, 256 (72%) were male, and 101 (28%) were female. The most common symptom was nasal obstruction (90%). Most of the benign cases were nasal polyps (90.2%), while the next most frequent diagnosis was inverted papilloma (4.7%). Malign neoplasms were found in 11 cases, and five were found to be squamous cell carcinomas (SCC). All benign cases were treated surgically, and the malignant cases were treated according to the diagnosis. In conclusion, although the symptoms of the 357 patients with sinonasal mass were similar, histopathological evaluation revealed 96.9% benign and 3.1% malign pathologies. The malign/benign ratio was 3.08. Malignancy should therefore be considered as a possibility in patients with nasal bleeding and facial swelling.