Sinonasal Teratocarcinosarcoma: Is Minimally Invasive Resection Followed by Adjuvant Histology-directed Chemoradiation a Better Alternative to Radical Excision? A Case Report
Dhaneshwor N Singh, Kanwar Sen, Arun K Sharma, Meenakshi Bharadwaj
Citation Information :
Singh DN, Sen K, Sharma AK, Bharadwaj M. Sinonasal Teratocarcinosarcoma: Is Minimally Invasive Resection Followed by Adjuvant Histology-directed Chemoradiation a Better Alternative to Radical Excision? A Case Report. Int J Otorhinolaryngol Clin 2019; 11 (1):9-11.
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.
Heffner DK, Hyams VJ. Teratocarcinosarcoma (malignant teratoma?) of the nasal cavity and paranasal sinuses. A clinicopathologic study of 20 cases. Cancer 1984;53(10):2140–2154. DOI: 10.1002/1097-0142(19840515)53:10<2140::AID-CNCR2820531025>3.0.CO;2-Y.
Budrukkar A, Agarwal JP, Kane S, et al. Management and clinical outcome of sinonasal teratocarcinosarcoma: single-institution experience. J Laryngol Otol 2010;124(7):739–743. DOI: 10.1017/S0022215109992866.
Kane SV, Karpate AA, Bal M, et al. Chemotherapy-induced neuronal maturation in sinonasal teratocarcinosarcoma—a unique observation. Head Neck Pathol 2009;3(1):31–36. DOI: 10.1007/s12105-008-0094-x.
Pai SA, Naresh KN, Masih K, et al. Teratocarcinosarcoma of the paranasal sinuses: a clinicopathologic and immunohistochemical study. Hum Pathol 1998;29(7):718–722. DOI: 10.1016/S0046-8177(98)90281-7.
Smith SL, Hessel AC, Luna MA, et al. Sinonasal teratocarcinosarcoma of the head and neck: a report of 10 patients treated at a single institution and comparison with reported series. Arch Otolaryngol Head Neck Surg 2008;134(6):592–595. DOI: 10.1001/archotol.134.6.592.
Zainul AS, Shabbir A, Montasir J, et al. Sinonasal teratocarcinosarcoma. J Pak Med Assoc 2012;62(6):633–635.
Wei S, Carroll W, Lazenby A, et al. Sinonasalteratocarcinosarcoma: report of a case with review of the literature and treatment outcome. Ann Diagn Pathol 2008;12(6):415–425. DOI: 10.1016/j.anndiagpath.2007.05.003.
Sharma HS, Abdullah JM, Othman NH, et al. Teratocarcinosarcoma of the nasal cavity and ethmoid. J Laryngol Otol 1998;112(7):682–686. DOI: 10.1017/S0022215100141453.
Nitsche M, Hermann R, Christiansen H, et al. Rationale for individualized therapy in sinonasal teratocarcinosarcoma (SNTC): case report. Onkologie 2005;28(12):653–656.