Sinonasal teratocarcinosarcoma - A rare case report

Abstract

Sinonasal teratocarcinosarcoma is a rare and highly malignant tumor characterized by complex admixture of teratomatous and carcinosarcomatous component. Here, we report a case of 72-year-old male presented with complaints of epistaxis, recurrent sinusitis,
nasal stuffiness, and nasal blockade for past 5-6 months and his computed tomography report revealed as an inflammatory sinonasal disease with polyposis. Histopathology examination showed fragments of upper respiratory mucosa admixed with fragments of
tumor composed of benign and malignant counterparts of both epithelial and mesenchymal components in a variety of histologic patterns. Also noted were the characteristic squamous epithelium with “fetal-type” clear cells, areas of necrosis, mitotic figure and sheets of undifferentiated blastemal like cells. Immunohistochemistry demonstrated positive staining for cytokeratin, epithelial membrane antigen, vimentin, synaptophysin, S-100, chromogranin, and CD99. This polyimmunophenotypic characteristic and diverse histological differentiation provided the basis for the diagnosis. Knowing its highly aggressive behavior, the patient should be treated aggressively and followed up closely.