Sinonasal teratocarcinosarcoma treated via endonasal endoscopic approach and CyberKnife radiotherapy: A case report and review of the literature

Teratocarcinosarcoma is an extremely invasive high-grade malignancy that develops in the nasal cavity and paranasal sinus, with pathological features of both teratoma and carcinosarcoma. Here, we present a case of primary teratocarcinosarcoma in the sphenoid sinus along with a review of the literatu...

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Main Authors: Shiori Tanaka, Hidenori Yokoi, Kohei Inomata, Keisuke Maruyama, Masachika Fujiwara, Arisa Ohara, Shoji Naito, Koichiro Saito
Format: Article
Language:English
Published: Elsevier 2023-06-01
Series:Current Problems in Cancer: Case Reports
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S2666621923000182
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author Shiori Tanaka
Hidenori Yokoi
Kohei Inomata
Keisuke Maruyama
Masachika Fujiwara
Arisa Ohara
Shoji Naito
Koichiro Saito
author_facet Shiori Tanaka
Hidenori Yokoi
Kohei Inomata
Keisuke Maruyama
Masachika Fujiwara
Arisa Ohara
Shoji Naito
Koichiro Saito
author_sort Shiori Tanaka
collection DOAJ
description Teratocarcinosarcoma is an extremely invasive high-grade malignancy that develops in the nasal cavity and paranasal sinus, with pathological features of both teratoma and carcinosarcoma. Here, we present a case of primary teratocarcinosarcoma in the sphenoid sinus along with a review of the literature. A 70-year-old woman presented to our hospital with chief complaints of diplopia, photophobia in the right eye, and dull pain in the back of the right eyeball. Ophthalmological examination showed no abnormalities, and head magnetic resonance imaging showed a tumoral lesion extending from the sella turcica to the sphenoid sinus. Endonasal endoscopic removal of the malignant tumor was performed under general anesthesia. Intraoperative findings revealed that the posterior wall of the sphenoid sinus had thinned out because of compression by the tumor, which had adhered to the dura mater and internal carotid artery. This made total excision difficult, and the tumor was removed as much as possible. Based on pathological examination, the tumor was diagnosed as a teratocarcinosarcoma. Since postoperative magnetic resonance imaging suggested the presence of residual tumor, irradiation was administered at a dose of 36 Gy in 12 fractions with CyberKnife. Subjective symptoms, including diplopia, showed improvement, and imaging showed regression of the lesion. The patient has had an uneventful course without recurrence for 40 months. Maximal safe excision via endonasal endoscopic approach combined with the use of CyberKnife is a potentially useful and minimally invasive treatment method for teratocarcinosarcoma in the sphenoid sinus.
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spelling doaj.art-92a8f573ad7543a0a5ea2100070384952023-06-18T05:03:31ZengElsevierCurrent Problems in Cancer: Case Reports2666-62192023-06-0110100233Sinonasal teratocarcinosarcoma treated via endonasal endoscopic approach and CyberKnife radiotherapy: A case report and review of the literatureShiori Tanaka0Hidenori Yokoi1Kohei Inomata2Keisuke Maruyama3Masachika Fujiwara4Arisa Ohara5Shoji Naito6Koichiro Saito7Department of Otolaryngology, Head and Neck Surgery, Kyorin University School of Medicine, Tokyo 181-8611, JapanDepartment of Otolaryngology, Head and Neck Surgery, Kyorin University School of Medicine, Tokyo 181-8611, Japan; Corresponding author.Department of Otolaryngology, Head and Neck Surgery, Kyorin University School of Medicine, Tokyo 181-8611, JapanDepartment of Neurosurgery, Kyorin University School of Medicine, Tokyo 181-8611, JapanDepartment of Pathology, Kyorin University School of Medicine, Tokyo 181-8611, JapanDepartment of Radiology, Kyorin University School of Medicine, Tokyo 181-8611, JapanDepartment of Otolaryngology, Head and Neck Surgery, Kyorin University School of Medicine, Tokyo 181-8611, JapanDepartment of Otolaryngology, Head and Neck Surgery, Kyorin University School of Medicine, Tokyo 181-8611, JapanTeratocarcinosarcoma is an extremely invasive high-grade malignancy that develops in the nasal cavity and paranasal sinus, with pathological features of both teratoma and carcinosarcoma. Here, we present a case of primary teratocarcinosarcoma in the sphenoid sinus along with a review of the literature. A 70-year-old woman presented to our hospital with chief complaints of diplopia, photophobia in the right eye, and dull pain in the back of the right eyeball. Ophthalmological examination showed no abnormalities, and head magnetic resonance imaging showed a tumoral lesion extending from the sella turcica to the sphenoid sinus. Endonasal endoscopic removal of the malignant tumor was performed under general anesthesia. Intraoperative findings revealed that the posterior wall of the sphenoid sinus had thinned out because of compression by the tumor, which had adhered to the dura mater and internal carotid artery. This made total excision difficult, and the tumor was removed as much as possible. Based on pathological examination, the tumor was diagnosed as a teratocarcinosarcoma. Since postoperative magnetic resonance imaging suggested the presence of residual tumor, irradiation was administered at a dose of 36 Gy in 12 fractions with CyberKnife. Subjective symptoms, including diplopia, showed improvement, and imaging showed regression of the lesion. The patient has had an uneventful course without recurrence for 40 months. Maximal safe excision via endonasal endoscopic approach combined with the use of CyberKnife is a potentially useful and minimally invasive treatment method for teratocarcinosarcoma in the sphenoid sinus.http://www.sciencedirect.com/science/article/pii/S2666621923000182Sphenoid sinusTeratocarcinosarcomaOcular manifestationDebulking, CyberKnifeCase report
spellingShingle Shiori Tanaka
Hidenori Yokoi
Kohei Inomata
Keisuke Maruyama
Masachika Fujiwara
Arisa Ohara
Shoji Naito
Koichiro Saito
Sinonasal teratocarcinosarcoma treated via endonasal endoscopic approach and CyberKnife radiotherapy: A case report and review of the literature
Current Problems in Cancer: Case Reports
Sphenoid sinus
Teratocarcinosarcoma
Ocular manifestation
Debulking, CyberKnife
Case report
title Sinonasal teratocarcinosarcoma treated via endonasal endoscopic approach and CyberKnife radiotherapy: A case report and review of the literature
title_full Sinonasal teratocarcinosarcoma treated via endonasal endoscopic approach and CyberKnife radiotherapy: A case report and review of the literature
title_fullStr Sinonasal teratocarcinosarcoma treated via endonasal endoscopic approach and CyberKnife radiotherapy: A case report and review of the literature
title_full_unstemmed Sinonasal teratocarcinosarcoma treated via endonasal endoscopic approach and CyberKnife radiotherapy: A case report and review of the literature
title_short Sinonasal teratocarcinosarcoma treated via endonasal endoscopic approach and CyberKnife radiotherapy: A case report and review of the literature
title_sort sinonasal teratocarcinosarcoma treated via endonasal endoscopic approach and cyberknife radiotherapy a case report and review of the literature
topic Sphenoid sinus
Teratocarcinosarcoma
Ocular manifestation
Debulking, CyberKnife
Case report
url http://www.sciencedirect.com/science/article/pii/S2666621923000182
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