title: Management of sinonasal teratocarcinosarcoma: a systematic review.
abstract: OBJECTIVE
  Sinonasal teratocarcinosarcoma (SNTCS) is a rare and highly malignant neoplasm that often involves the anterior skull base. This study reviews the published literature related to SNTCS. Clinical presentation, demographics, radiographic diagnosis, pathology, treatment, and management outcomes of this uncommon disease are reported.
  
  
  METHODS
  A systematic review in the published English literature was conducted. A MEDLINE/PubMed search and bibliographic examination of articles pertaining to SNTCS were performed. Each case was analyzed for patient demographics, clinical presentation, tumor location, diagnosis, treatment, and survival outcome.
  
  
  RESULTS
  A total of 49 journal articles were included. Individual patient data were reported in 86 cases. The average age of the patients was 54.5 years (range, 0.1 to 85 years), with a strong male predilection (7:1). Average follow-up was found to be 38.9 months (range, 2 to 372 months). The most common treatment method was surgery with radiation therapy, utilized in 59.3% of patients. Out of 71 cases with reported outcome and follow-up, there were 21 cases of recurrence, 8 cases with metastasis, and 6 cases reporting both recurrence and metastasis. Forty-two out of 71 (59.2%) patients survived at the time of follow-up.
  
  
  CONCLUSIONS
  This study describes the largest pool of SNTCS patients to date. SNTCS is a rare and aggressive malignant skull base tumor with a poor prognosis with frequent recurrence and metastasis. Although a variety of treatment paradigms have been reported in the literature, radical surgical resection followed by radiation therapy appears to be the most commonly used treatment option.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, University of Medicine and Dentistry of New Jersey, New Jersey Medical School, Newark, NJ, USA.
authors.forename: Poonam
authors.initials: P
authors.lastname: Misra
authors.forename: Qasim
authors.initials: Q
authors.lastname: Husain
authors.forename: Peter F
authors.initials: PF
authors.lastname: Svider
authors.forename: Saurin
authors.initials: S
authors.lastname: Sanghvi
authors.forename: James K
authors.initials: JK
authors.lastname: Liu
authors.forename: Jean Anderson
authors.initials: JA
authors.lastname: Eloy
mesh_terms: D002296:Carcinosarcoma / Q000150:complications / Q000175:diagnosis / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery*; D003131:Combined Modality Therapy; D006801:Humans; D015508:Nasal Obstruction / Q000209:etiology; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology; D009669:Nose Neoplasms / Q000150:complications / Q000175:diagnosis / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery*; D013517:Otorhinolaryngologic Surgical Procedures / Q000379:methods; D010255:Paranasal Sinus Neoplasms / Q000150:complications / Q000175:diagnosis / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery*; D013724:Teratoma / Q000150:complications / Q000175:diagnosis / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery*