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A Report of 10 Patients Treated at a Single Institution and Comparison With Reported Series

Stacey L. Smith, MD; Amy C. Hessel, MD; Mario A. Luna, MD; Anais Malpica, MD; David I. Rosenthal, MD; Adel K. El-Naggar, MD, PhD

Arch Otolaryngol Head Neck Surg. 2008;134(6):592-595.

Objectives  To present the clinicopathologic features of 10 sinonasal teratocarcinosarcomas managed at a single center. Teratocarcinosarcoma is a rare morphologically heterogeneous and highly malignant neoplasm. Previous reports of these tumors have focused on their differential diagnosis and histogenesis and consisted of individual case reports and consultation based series.

Design  Review of patient medical records and microscopic slides of all tumor tissues. The histopathologic features for each tumor and the demographic, clinical, treatment, and follow-up information were recorded for each patient. Also, a comparison with previously reported series was performed.

Setting  The University of Texas M. D. Anderson Cancer Center.

Patients  Ten men ranging in age from 35 to 69 years (mean age, 53 years) were included in the study. They all experienced a short course of symptoms, with an average duration of 3.5 months, and 9 presented with nasal obstruction and epistaxis. Nine patients were treated with both surgery and irradiation.

Results  Histologically, the tumors showed primitive neuroepithelial elements and various malignant epithelial and mesenchymal components. Six patients had no evidence of disease by the end of follow-up, which ranged from 72 to 372 months. Three patients died of disease, and 1 patient was lost to follow-up.

Conclusion  Sinonasal teratocarcinosarcoma of the head and neck is a histologically and biologically heterogeneous malignant neoplasm that is best managed with surgery and postoperative radiotherapy.

Author Affiliations: Department of Head and Neck Surgery, The University of Texas Medical School (Dr Smith), and the Departments of Head and Neck Surgery (Drs Hessel and El-Naggar), Pathology (Drs Luna, Malpica, and El-Naggar), and Radiation Oncology (Dr Rosenthal), The University of Texas M. D. Anderson Cancer Center, Houston.