Rationale for individualized therapy in Sinonasal Teratocarcinosarcoma (SNTC): case report.
BACKGROUND
Sinonasal Teratocarcinosarcoma (SNTC) is a very unusual and aggressive neoplasm characterized by the combination of malignant teratoma and carcinosarcoma features. We present the first case of malignant SNTC treated with individualized multimodal therapy including a histology-specific chemotherapy.


METHODS
A 31-year-old man presented with an obstruction of the right pansinus. Histology showed an SNTC with major parts of small cell, poorly differentiated carcinoma and a small proportion of highly differentiated embryonal rhabdomyosarcoma. An operation was performed followed by intraoperative application of a 5-FU ointment. Adjuvant chemotherapy with cisplatin, etoposid and ifosfamid were given in regard to the major components of this heterogeneous tumor. Radiotherapy up to 59.4 Gy was applied.


CONCLUSIONS
36 months after the end of therapy, there is no sign of tumor recurrence or metastasis in our patient. We suggest that surgery, radiotherapy and a histology-specific multidrug chemotherapy seems to be a therapeutic approach that is appropriate for this heterogeneous tumor.
Nitsche
Mirko
M
Department of Radiotherapy, University of Göttingen, Germany. mnitsche@med.uni-goettingen.de
Hermann
Robert Michael
RM
Christiansen
Hans
H
Berger
Joachim
J
Pradier
Olivier
O
D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002296:Carcinosarcoma / Q000473:pathology / Q000628:therapy*; D002945:Cisplatin / Q000627:therapeutic use; D003131:Combined Modality Therapy; D005047:Etoposide / Q000627:therapeutic use; D005472:Fluorouracil / Q000627:therapeutic use; D013502:General Surgery; D006801:Humans; D007069:Ifosfamide / Q000627:therapeutic use; D008297:Male; D009669:Nose Neoplasms / Q000473:pathology / Q000628:therapy*; D010255:Paranasal Sinus Neoplasms / Q000473:pathology / Q000628:therapy*; D018714:Radiotherapy, Adjuvant; D018243:Teratocarcinoma / Q000473:pathology / Q000628:therapy*; D016896:Treatment Outcome
D005047:Etoposide; D002945:Cisplatin; D005472:Fluorouracil; D007069:Ifosfamide