[P-29] Sinonasal teratocarcinosarcoma: a case report of uncommon sinonasal malignant tumour

Fitriana M.N. and Usman H.A.

Anatomical Pathology Department, Faculty of Medicine, Universitas Padjadjaran / Dr Hasan Hasan Sadikin General Hospital, Bandung, Indonesia

Background: Sinonasal teratocarcinosarcoma is rare malignant tumour arising in sinonasal region. On Histopathological examination, this tumour is characterised by the combination of benign and malignant components of epithelial, mesenchymal and teratoid elements. Sinonasal teratocarcinosarcoma is more common in male, tends to locally damage with high recurrence rate.

Case Presentation: A 30-year-old man presented with chronic nasal obstruction and bleeding discharge for the past two month. Physical examination and CT scan revealed a mass occupying left ethmoid sinus. Histopathological examination showed admixture of carcinoma, immature neuroectodermal component and sarcoma. Immunohistochemistry was applied to each component.

Discussion and Conclusion: Terminology of teratocarcinosarcoma is established when there are carcinomatous and sarcomatous tissues with teratoma component. Histopathological examination of our tumour revealed area of adenocarcinoma. In addition, area of rhabdomyosarcoma was also characterised. In some parts, there was a structure resembling primitive neuroectodermal tumour which was confirmed by positive immunoexpression of CD99, NSE, chromogranin and CD56. Furthermore, myogenin expression was positive in rhabdomyosarcoma part. Therapy of sinonasal teratocarcinosarcoma is a combination of surgery, radiotherapy and chemotherapy. After surgery, our patient was received radiotherapy. His recent condition is still stable.