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

JOURNAL TITLE: An International Journal Clinical Rhinology

Author
1. Sudhir Naik
2. Nanjundappa
3. Rajshekar Halkud
4. Srihariprasad
5. K Sidappa
6. Sumit Gupta
7. Clementina Rama Rao
ISSN
0974-4630
DOI
10.5005/jp-journals-10013-1131
Volume
5
Issue
3
Publishing Year
2012
Pages
5
Author Affiliations
    1. Leicester, UK
    2. New Delhi, India
    3. Skinnovation Clinics, GNH Excel Medical Center, Sir Ganga Ram Hospital, Northern Central Railway Hospital, New Delhi, India
    4. Sir Ganga Ram Hospital, New Delhi, India
    1. Assistant Professor in ENT and Head and Neck Surgery, KVG Medical College Hospital, Sullia, Karnataka, India
    1. Department of Head and Neck Oncosurgery, Kidwai Memorial Institute of Oncology, Bengaluru, Karnataka, India
    1. Department of Head and Neck Oncosurgery Kidwai Memorial Institute of Oncology, Bengaluru, Karnataka, India
    1. Department of Head and Neck Oncosurgery, Kidwai Memorial Institute of Oncology, Bengaluru, Karnataka, India
    1. Department of Head and Neck Oncosurgery Kidwai Memorial Institute of Oncology, Bengaluru, Karnataka, India
    1. Department of Pathology, Kidwai Memorial Institute of Oncology, Bengaluru, Karnataka, India
  • Article keywords
    Teratocarcinosarcoma, Sinonasal, Immunohistochemistry, Medial maxillectomy, Multimodality treatment

    Abstract

    Background/objectives

    Sinonasal teratocarcinosarcoma is a rare aggressive malignant tumor arising in the sinonasal tract and a malignant neoplasm of uncertain histogenesis. As the tumor contains various components of teratoma, sarcoma and carcinoma arising from cells of embryonic origin majority of the patients suffer locoregional failure.

    Case report

    A 35-year-old patient reported with history of left-sided nasal obstruction since 2 months. A polypoid mass was seen in the left nasal cavity and a clinical diagnosis of infected antrochoanal polyp endoscopic sinus surgery was done. Histopathology with immunohistochemistry confirmation yielded the report as teratocarcinosarcoma.

    Intervention

    Medial maxillectomy with a Moure's incision was done with adjuvant intensity modulated radiotherapy and chemotherapy. Histopathological analysis of the specimen confirmed the earlier pathology.

    Conclusion

    Sinonasal teratocarcinosarcoma has a proven poor prognosis with locoregional recurrence. The disease free survival rate is nearly 28% and overall survival rate is of 46%. Optimal resection margins are to be defined and multimodality treatment in the form of postoperative radiotherapy and chemotherapy are to be standardized.

    How to cite this article

    Naik SM, Nanjundappa, Halkud R, Srihariprasad, Sidappa K, Gupta S, Rao CR. Sinonasal Teratocarcinosarcoma: A Rare Clinical Entity managed by Medial Maxillectomy and Adjuvant Chemoradiation. Clin Rhinol An Int J 2012;5(3):118-122.

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