Sinonasal Teratocarcinosarcoma: A Rare Clinical Entity managed by Medial Maxillectomy and Adjuvant Chemoradiation

Background/objectives: Sinonasal teratocarcinosarcoma is a rare aggressive malignant tumor arising in the sinonasal tract and a malignant neoplasm of uncertain histogenesis. As the tumor contains various components of teratoma, sarcoma and carcinoma arising from cells of embryonic origin majority of the patients suffer locoregional failure. Case report: A 35-year-old patient reported with history of leftsided nasal obstruction since 2 months. A polypoid mass was seen in the left nasal cavity and a clinical diagnosis of infected antrochoanal polyp endoscopic sinus surgery was done. Histopathology with immunohistochemistry confirmation yielded the report as teratocarcinosarcoma. Intervention: Medial maxillectomy with a Moure’s incision was done with adjuvant intensity modulated radiotherapy and chemotherapy. Histopathological analysis of the specimen confirmed the earlier pathology. Conclusion: Sinonasal teratocarcinosarcoma has a proven poor prognosis with locoregional recurrence. The disease free survival rate is nearly 28% and overall survival rate is of 46%. Optimal resection margins are to be defined and multimodality treatment in the form of postoperative radiotherapy and chemotherapy are to be standardized.