Sinonasal teratocarcinosarcoma in a 57-year-old Thai man: a case report

Main Article Content

Kulachet Wiwatwarayos


Sinonasal teratocarcinosarcoma (TCS) is a rare aggressive malignant tumor. This tumor is exclusively found in the sinonasal tract. Clinical manifestations are associated with mass effects, such as nasal obstruction, headache and epistaxis.

Histopathologically, the tumor consists of a mixture of epithelial, mesenchymal, and neuroepithelial elements.

In this report, we are presenting a case of sinunasal TCS a 57-year-old Thai man, who presented with epistaxis. The nasal mass was revealed to extend to right anterior cranial fossa.

Article Details

รายงานผู้ป่วย (Case Report)


WHO Classification of Tumours Editorial Board. Head and neck tumours [Internet; beta version ahead of print]. Lyon (France): International Agency for Research on Cancer; 2022 [cited 2022 Dec 10]. (WHO classification of tumours series, 5th ed.; vol. 9). Available from:

Fatima SS, Minhas K, Din NU, Fatima S, Ahmed A, Ahmad Z. Sinonasal teratocarcinosarcoma: a clinicopathologic and immunohistochemical study of 6 cases. Annals of Diagnostic Pathology. 2013 Aug 1;17(4):313-8.

Chakraborty S, Chowdhury AR, Bandyopadhyay G. Sinonasal teratocarcinosarcoma: case report of an unusual neoplasm. Journal of Oral and Maxillofacial Pathology: JOMFP. 2016 Jan;20(1):147.

Shanmugaratnam K, Kunaratnam N, Chia KB, Chiang GS, Sinniah R. Teratoid carcinosarcoma of the paranasal sinuses. Pathology. 1983 Oct;15(4):413-9. doi: 10.3109/00313028309085168. PMID: 6674870.

Salem F, Rosenblum MK, Jhanwar SC, Kancherla P, Ghossein RA, Carlson DL. Teratocarcinosarcoma of the nasal cavity and paranasal sinuses: report of 3 cases with assessment for chromosome 12p status. Hum Pathol. 2008 Apr;39(4):605-9. doi: 10.1016/j.humpath.2007.09.002. Epub 2008 Mar 4. PMID: 18284932.

Kurmi DJ, Mittal RS, Sharma A, Gandhi A, Singhvi S. Sinonasal teratocarcinosarcoma involving nasal cavity, nasopharynx, and all paranasal sinuses with bilateral orbital and intracranial extension: A rare case report. Asian J Neurosurg. 2017 Apr-Jun;12(2):232-240. doi: 10.4103/1793-5482.145559. PMID: 28484539; PMCID: PMC5409375.

Gnepp DR, Bishop JA. Gnepp's Diagnostic Surgical Pathology of the Head and Neck E-Book. Elsevier Health Sciences; 2020 May 5.

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 Jun;134(6):592-5. doi: 10.1001/archotol.134.6.592. PMID: 18559724.

Rooper LM, Uddin N, Gagan J, Brosens LAA, Magliocca KR, Edgar MA, Thompson LDR, Agaimy A, Bishop JA. Recurrent Loss of SMARCA4 in Sinonasal Teratocarcinosarcoma. Am J Surg Pathol. 2020 Oct;44(10):1331-1339. doi: 10.1097/PAS.0000000000001508. PMID: 32520761.

Rooper LM, Agaimy A, Gagan J, Simpson RHW, Thompson LDR, Trzcinska AM, Ud Din N, Bishop JA. Comprehensive Molecular Profiling of Sinonasal Teratocarcinosarcoma Highlights Recurrent SMARCA4 Inactivation and CTNNB1 Mutations. Am J Surg Pathol. 2022 Oct 10. doi: 10.1097/PAS.0000000000001976. Epub ahead of print. PMID: 36206446.

Birkeland AC, Burgin SJ, Yanik M, Scott MV, Bradford CR, McHugh JB, McLean SA, Sullivan SE, Nor JE, McKean EL, Brenner JC. Pathogenetic Analysis of Sinonasal Teratocarcinosarcomas Reveal Actionable β-catenin Overexpression and a β-catenin Mutation. J Neurol Surg B Skull Base. 2017 Aug;78(4):346-352. doi: 10.1055/s-0037-1601320. Epub 2017 Mar 27. PMID: 28725522; PMCID: PMC5515660.

Vranic S, Caughron SK, Djuricic S, Bilalovic N, Zaman S, Suljevic I, Lydiatt WM, Emanuel J, Gatalica Z. Hamartomas, teratomas and teratocarcinosarcomas of the head and neck: Report of 3 new cases with clinico-pathologic correlation, cytogenetic analysis, and review of the literature. BMC Ear Nose Throat Disord. 2008 Nov 24;8:8. doi: 10.1186/1472-6815-8-8. PMID: 19025657; PMCID: PMC2611960.

Wei S, Carroll W, Lazenby A, Bell W, Lopez R, Said-Al-Naief N. Sinonasal teratocarcinosarcoma: report of a case with review of literature and treatment outcome. Annals of Diagnostic Pathology. 2008 Dec 1;12(6):415-25.

Nitsche M, Hermann RM, Christiansen H, Berger J, Pradier O. Rationale for individualized therapy in Sinonasal Teratocarcinosarcoma (SNTC): case report. Onkologie. 2005 Dec;28(12):653-6. doi: 10.1159/000089146. Epub 2005 Dec 1. PMID: 16330889.

Chapurin N, Totten DJ, Morse JC, Khurram MS, Louis PC, Sinard RJ, Chowdhury NI. Treatment of sinonasal teratocarcinosarcoma: a systematic review and survival analysis. American Journal of Rhinology & Allergy. 2021 Jan;35(1):132-41.

Carrizo F, Pineda-Daboin K, Neto AG, Luna MA. Pharyngeal teratocarcinosarcoma: review of the literature and report of two cases. Annals of Diagnostic Pathology. 2006 Dec 1;10(6):339-42.

Heffner, D.K. and Hyams, V.J., 1984. Teratocarcinosarcoma (malignant teratoma?) of the nasal cavity and paranasal sinuses: a clinicopathologic study of 20 cases. Cancer, 53(10), pp.2140-2154.

Rao YF, Cheng DN, Qiu K, Song Y, Zhao Y, Gu D, Ren J. Sinonasal teratocarcinosarcoma: a case report and literature review. J Int Med Res. 2020 Dec;48(12):300060520971488. doi: 10.1177/0300060520971488. PMID: 33342340; PMCID: PMC7754799.

Peralta Suarez G, Dibs K, Carrau RL, et al, Sinonasal teratocarcinosarcoma: a therapeutic dilemma, BMJ Case Reports CP 2022;15:e252429.

Kazemian A, DEHGHAN MH, SARDARI KM. Sinonasal Teratocarcinosarcoma; Report of a case.

Mohamed Reda El Ochi, Amine Essaoudi, Abderrahim El Ktaibi, Amal Damiri, Hafsa Chahdi, Mohamed Oukabli, Teratocarcinosarcoma of the cheek: a case report, Journal of Surgical Case Reports, Volume 2022, Issue 4, April 2022, rjac169,