Sinonasal Teratocarcinosarcoma: A Rare Case Report

Authors

  • Ashwini Sudhakar Bodhgire Department of Pathology, Government Medical College, Aurangabad (Chh. Sambhajinagar), Maharashtra, India.
  • Shweta Dattakumar Ganorkar Department of Pathology, Government Medical College, Aurangabad (Chh. Sambhajinagar), Maharashtra, India.
  • Anjali Sanjay Kulkarni Department of Pathology, Government Medical College, Aurangabad (Chh. Sambhajinagar), Maharashtra, India.

DOI:

https://doi.org/10.21276/apalm.3592

Keywords:

Nasal polyps, nasal cavity, Polyp, SNTCS

Abstract

Background: Teratocarcinosarcoma is a type of malignancy that typically arises from germ cells. A teratocarcinoma in the nose would present as an unusual or rare clinical case, requiring imaging and biopsy for confirmation. It constitutes less than 1% of all cancers and approximately 3% of all malignancies of the head and neck region; only a few hundred cases have been reported worldwide. Because of its rarity, clinical presentation, and treatment challenges, it is essential to report and study cases of nasal teratocarcinoma.

Case Presentation: We here report a case of Sinonasal Teratocarcinosarcoma (SNTCS), a 55-year-old female with a complaint of right-sided nasal blockage for over a month with a nasal bleed for one day. On local examination, there was swelling of the right alar region and dorsum with DNS to the left side and tenderness in all paranasal sinuses. There was no fogging on the right side. On anterior rhinoscopy, a chocolate-brown polypoidal mass obscuring the view of the floor, roof, cavity, and middle turbinate was seen. On histopathological examination, it was diagnosed as teratocarcinosarcoma of the nasal cavity. Immunohistochemistry confirmed the diagnosis. On follow-up, her condition deteriorated and she succumbed to death in the next 6 months.

Conclusion: Teratocarcinosarcoma is a rare and aggressive sinonasal tumor with a hypothesized origin from somatic pluripotent stem cells of the nasal cavity. Its early diagnosis is important as it carries a poor prognosis.

References

1. Carrizo F, Pineda-Daboin K, Neto AG, Luna MA. Pharyngeal teratocarcinosarcoma: review of the literature and report of two cases. Ann Diagn Pathol. 2006;10(6):339-342.

2. Cardesa A, Luna MA. Sinonasal teratocarcinosarcoma. In: Barnes L, Eveson JD, Reichart P, et al., eds. World Health Organization classification of tumors. Pathology and genetics of head and neck tumors. Lyon: IARC Press; 2005:76-77.

3. Chapurin N, Totten DJ, Morse JC, et al. Treatment of sinonasal teratocarcinosarcoma: a systematic review and survival analysis. Am J Rhinol Allergy. 2021;35(1):132-141.

4. Heffner DK, Hyams VJ. Teratocarcinosarcoma (malignant teratoma?) of the nasal cavity and paranasal sinuses: A clinicopathologic study of 20 cases. Cancer. 1984;53(10):2140-2154.

5. Peralta Suarez G, Dibs K, Carrau RL, Schoenfield L, Blakaj DM, Tinoco G. Sinonasal teratocarcinosarcoma: a therapeutic dilemma. BMJ Case Rep. 2022;15(11):e252429.

6. Misra P, Husain Q, Svider PF, et al. Management of sinonasal teratocarcinosarcoma: a systematic review. Am J Otolaryngol. 2014:35(1):5-11.

7. Wang SY, Li SM, et al. Pathological features and diagnosis of teratocarcinoma sarcoma in nasal cavity and paranasal sinuses. Chin J Pathol. 2007;36(8):534-538.

8. Chapurin N. Totten DJ, Morse JC, Khurram MS, Louis PC, Sinard RJ, Chowdhury NI. Treatment of Sinonasal Teratocarcinosarcoma: A Systematic Review and Survival Analysis. Am J Rhinol Allergy. 2021 Jan;35(1):132-141.

9. Wassef SN, Kapur P, Barnett SL, et al. Sinonasal teratocarcinosarcoma with intracranial extension: case report and literature review. Ear Nose Throat J. 2012:91:536-539.

10. Rotenberg B. El-Hakim H, Lodha A, et al. Nasopharyngeal teratocarcinosarcoma. Int J Pediatr Otorhinolaryngol. 2002;62:159-164.

11. Smith SL, Hessel AC, Luna MA, Malpica A, Rosenthal DI, ElNaggar AK. Sinonasal teratocarcinosarcoma of the head and neck: A report of 10 patients treated at a single institution and comparison with reported series. Arch Otolaryngol Head Neck Surg. 2008:134:592-95.

12. Budrukkar A, Agarwal JP, Kane S, Siddha M, Laskar SG, Pai P, et al. Management and clinical outcome of sinonasal teratocarcinosarcoma: Single institution experience. J Laryngol Otol. 2010;124:739-43.

13. Tchoyoson Lim CC, Thiagarajan A, Sim CS, Khoo ML, Shakespeare TP, Ng I. Craniospinal dissemination in teratocarcinosarcoma. J Neurosurg. 2008;109(2):321-24.

14. Fu LY, Yang MY, Ye PY, Wang ZC, Chen CJ, Li H, Xu SW. Sinonasal teratocarcinosarcoma involving the nasal cavity, unilateral paranasal sinuses, and intracranial invasion: A case report. World J Clin Cases. 2024 Sep 6;12(25):5784.

15. Soman A, Prasad PH, Ajayan PV. Sinonasal teratocarcinosarcoma in an adolescent male: A case report of an unusual neoplasm. Indian J Pathol Microbiol. 2024 Apr 1:67(2):415-8.

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Published

20-09-2025

How to Cite

1.
Bodhgire AS, Ganorkar SD, Kulkarni AS. Sinonasal Teratocarcinosarcoma: A Rare Case Report. Ann of Pathol and Lab Med [Internet]. 2025 Sep. 20 [cited 2025 Dec. 5];12(9):C155-C158. Available from: https://pacificejournals.com/journal/index.php/apalm/article/view/3592

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Section

Case Report