Rebecca Tian Mei Au, Clarence Hai Yi Teo, Manish Bundele

 

Sinonasal teratocarcinosarcoma (SNTCS) is a malignant sinonasal tract neoplasm of uncertain histogenesis, with the stem or pluripotential progenitor cell with multidirectional differentiation postulated to be a likely candidate to the origin of the tumour.^1,2 Histologically, SNTCS is composed of mixed epithelial, mesenchymal, and neuroepithelial elements. The epithelial components can include both squamous epithelium and glandular structures, frequently with a clear cell appearance reminiscent of fetal tissues. The mesenchymal components are most often composed of nondescript hypercellular fascicles of spindle cells, but areas of overt smooth muscle or of rhabdomyoblastic, adipocytic, cartilaginous, or osteoblastic differentiation can be seen. The neuroepithelial component consists of primitive epithelioid cells with large, hyperchromatic nuclei arranged in nests and sheets with a patchy neurofibrillary background and rosette formation.¹ The immunoprofile of SNTCS corresponds to its constituent elements.¹ Owing to its heterogeneous histologic appearance, adequate sampling and recognition of all the components of this type of tumour are needed for its correct diagnosis.² We hereby report a case of teratocarcinosarcoma of the right nasal cavity.

 

References

1. WHO Classification of Tumours Editorial Board. Head and neck tumours [Internet]. Lyon (France): International Agency for Research on Cancer; 2023 [cited 2024 Oct 16]. (WHO classification of tumours series, 5th ed.; vol. 9). Available from: https://tumourclassification.iarc.who.int/chapters/52.

2. Smith SL, Hessel AC, Luna MA, Malpica A, Rosenthal DI, El-Naggar 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(6):592-595. doi:10.1001/archotol.134.6.592.

Statement of originality: I declare that the entire submission is my own original work and contribution.