2008 Volume 47 Issue 5 Pages 381-385
Background : Sinonasal teratocarcinosarcoma (SNTCS) is a rare and highly malignant tumor arising from the nasal cavity and paranasal sinuses. Little is known about the characteristic cytological features of this tumor.
Case : A 49-year-old man presenting with a large mass occupying the nasal cavities underwent biopsy. Histopathologically, the specimens revealed abundant undifferentiated neuroepithelial tissue with components of immature chondroid tissue, atypical myoid tissue, along with the features adenocarcinoma, which led to the diagnosis of SNTCS. The primary tumor almost disappeared after chemoradiotherapy, but lung and pleural metastases appeared 3 months later. Brush and imprint cytology of the lung and pleural lesions showed loosely arranged short and spindle-shaped malignant cells with hyperchromatic round nuclei and scanty cytoplasm. The presence of immature mesenchymal cells suggested the possible diagnosis of metastasis from the SNTCS.
Conclusion : Diagnosis of SNTCS is not easy due to the mixed proliferation of various elements. Diagnosis is difficult from the cytopathological findings alone, but observation of the cell composition throughout may offer clues. Moreover, appropriate sampling of specimens from several portions is important to arrive at the correct diagnosis.
