PhiliPPine	Journal	of	otolaryngology-head	and	neck	Surgery																				Vol.	22	noS.	1	&	2	January	–June;	July	–	december	2007

UNDER THE MICROSCOPE

36	 	 PhiliPPine	Journal	of	otolaryngology-head	and	neck	Surgery

This is from a 76-year-old male with a fungating maxillary antral mass that extends 
into the nasal cavity.

Jose M. Carnate Jr., MD

Department of Pathology
College of Medicine - Philippine General Hospital
University of the Philippines Manila

Correspondence: Jose M. Carnate Jr., MD
University of the Philippines Manila
College of Medicine
Department of Pathology
547 Pedro Gil St., Ermita, Manila 1000
Phone (632) 526-4550
Fax (632) 400-3638
Email: jmcjpath@yahoo.com
Reprints will not be available from the author.

Sinonasal Teratoid Carcinosarcoma

Philipp J Otolaryngol Head Neck Surg 2007; 22 (1,2): 36 c  Philippine Society of Otolaryngology – Head and Neck Surgery, Inc.

Sinonasal teratoid carcinosarcoma was first described in 1984 and since then 60 cases have 
been reported. I have had the opportunity to encounter four cases locally, the first one in 1995, 
another in 2003 and two cases in 2006. There is a male predominance among cases and age has 
ranged from 18 to 79 years. The usual symptoms reported are epistaxis and nasal obstruction 
while the most common physical examination finding is that of a nasal cavity mass. A closer 
look shows a mass at the ethmoid sinus or maxillary antrum with secondary involvement of 
adjacent sinuses and soft tissue. The tumor is highly malignant rapidly invading adjacent soft 
tissues and bone and giving rise to regional node and distant metastases.  The reported aver-
age survival is 1.7 years after diagnosis, with less than 3% surviving beyond three years. Radical 
surgery, radiotherapy and chemotherapy have all been used with limited success. Histologic 
sections show a confusing array of teratomatous, sarcomatous and carcinomatous elements 
represented here by immature squamous and cartilaginous islands, atypical fibrosarcoma-like 
spindle cell stroma and infiltrating atypical adenocarcinomatous glands.

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neoplasm.   Pathology Res Prac. 1995 March; 191(2): 166-71; discussion 172-3.
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