Sinonasal teratocarcinosarcoma.

Sinonasal teratocarcinosarcoma (SNTCS) is a rare and aggressive neoplasm characterized by the combination of malignant teratoma and carcinosarcoma. Sinonasal teratocarcinosarcoma usually is found mainly among adults, and the common original sites of SNTCS were nasal cavities and paranasal sinuses. There are fewer than 50 reported SNTCS cases in the literature. The most common cause of treatment failure is local recurrence. Distant metastasis of SNTCS is seldom described because of the invasive character of the cancer. We report on a 52-year-old man with SNTCS involving the left sinonasal cavity. Recurrent cervical metastasis developed in the 18th, 23rd, and 28th month after initial sinonasal surgery. Despite multiple aggressive neck surgeries and postoperative adjuvant radiotherapy, the patient died of lung metastasis 43 months after the initial surgery. Our patient was younger than other reported patients with SNTCS; besides, good locoregional control and lung metastasis have not been reported previously. An aggressive elective neck dissection should be performed in the early disease stage, and more attention should be given to the soft tissue surrounding any possible lymphadenopathy. This may decrease the risk of lower cervical lymph node or distant metastasis in patients with SNTCS.