title: Sinonasal teratocarcinosarcoma: a clinical and pathological analysis.
abstract: The goal of this study was to assess the pathological and differential diagnoses of sinonasal teratocarcinosarcoma (SNTCS) in order to ultimately improve the diagnosis and treatment of this rare disease. Data from 2 cases of sinonasal teratocarcinosarcoma from the Wuxi People's Hospital (China) were analyzed. The clinical presentation for these patients consisted of nasal obstruction, epistaxis, and headache. On further physical examination, the presence of a polypoid mass was identified and, despite surgery and radiotherapy, both cases experienced recurrence. Histologically, the tumors showed a heterogeneous mixture of components from the 3 germ layers, primitive neuroepithelial elements, diagnostic immature squamous cell nests (clear cell nests), and various epithelial and mesenchymal components. Staining of the different germ layers corresponded with the appropriate immune markers. In case 1, the postradiotherapy resection specimen was completely dominated by a mature teratoma, with a complete absence of the corresponding adenocarcinoma and fibrosarcoma components. To date, this is the first study describing this composition within an SNTCS recurrent tumor. In summary, SNTCS is a rare tumor characterized by the presence of benign and malignant epithelial, mesenchymal, and dysembryomal components. Owing to its heterogeneous histologic appearance, adequate sampling and recognition of all SNTCS components are needed for future diagnosis. Currently, surgical removal, postoperative radiotherapy, and a histology-specific multidrug chemotherapy appear to be the best therapeutic approach. Future individualized therapy may also hold promise.
authors.affiliation: Wuxi People's Hospital, Nanjing Medical University, Wuxi, Jiangsu, People's Republic of China. ysd-zh@163.com
authors.forename: Shudong
authors.initials: S
authors.lastname: Yang
authors.forename: Rongchao
authors.initials: R
authors.lastname: Sun
authors.forename: Jiabei
authors.initials: J
authors.lastname: Liang
authors.forename: Zhiyi
authors.initials: Z
authors.lastname: Zhou
authors.forename: Jing
authors.initials: J
authors.lastname: Zhou
authors.forename: Jun
authors.initials: J
authors.lastname: Rui
mesh_terms: D000368:Aged; D014408:Biomarkers, Tumor / Q000378:metabolism; D002296:Carcinosarcoma / Q000150:complications / Q000175:diagnosis* / Q000378:metabolism / Q000628:therapy; D003131:Combined Modality Therapy; D004844:Epistaxis / Q000175:diagnosis / Q000209:etiology; D005260:Female; D006261:Headache / Q000175:diagnosis / Q000209:etiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D015508:Nasal Obstruction / Q000175:diagnosis / Q000209:etiology; D009364:Neoplasm Recurrence, Local; D009669:Nose Neoplasms / Q000150:complications / Q000175:diagnosis* / Q000378:metabolism / Q000628:therapy; D035583:Rare Diseases; D013724:Teratoma / Q000150:complications / Q000175:diagnosis* / Q000378:metabolism / Q000628:therapy; D016896:Treatment Outcome
chemical_list: D014408:Biomarkers, Tumor