Carcinosarcoma: a rare sinonasal malignancy with atypical behaviour
DOI:
https://doi.org/10.18203/issn.2454-5929.ijohns20230765Keywords:
Carcinosarcoma, Nasal cavity, Paranasal sinuses, Nose neoplasmsAbstract
Carcinosarcoma is an extremely rare neoplasm in the nasal cavity and in the paranasal sinus, with rapid growth and extensive local destruction. We report a case of a 61-year-old man with progressive left-side nasal obstruction and epiphora for six months. Imaging showed a massive mass lesion, mainly located in the left nasal cavity and ethmoid sinus, with no intracranial or orbital extension. Biopsy of the nasal mass revealed a poorly-differentiated squamous cell carcinoma associated with sarcomatous elements. Patient underwent an endoscopic transnasal resection. Definitive histopathologic analysis revealed a carcinosarcoma. Postoperative radiotherapy was, then, performed. After five years of follow-up, there is no evidence of tumor recurrence. This report highlights that even though despite the lack of optimal treatment protocol, long term disease control can be achieved through endoscopic transnasal resection complemented with radiotherapy.
References
Patel TD, Vázquez A, Plitt MA, Baredes S, Eloy JA. A case-control analysis of survival outcomes in sinonasal carcinosarcoma. Am J Otolaryngol Head Neck Med Surg. 2015;36:200-04.
Yuen J, Varadarajan V, Stavrakas M, Muquit S, Khalil H. A Case of Invasive Sinonasal Carcinosarcoma: The Importance of Early Detection. Case Rep Otolaryngol. 2018:1-5.
Hasnaoui J. Carcinosarcoma of the maxillary sinus: A rare case report. Ann Med Surg. 2017;19:41-4.
Kuo CC, Viola F, DeGiovanni JC, DeVictor S, Belles WJ. Carcinosarcoma of the Nasal Septum: A Case Report and Review of the Literature. Cureus. 2021;13:6-10.
Alotaiby F. Carcinosarcoma arising from inverted papilloma in a patient with history of radiotherapy for sinonasal squamous cell carcinoma. Am J Case Rep. 2020;21:1-4.
Erovic BM, Shah MD, Wasserman JK. Sinonasal carcinosarcoma: analysis of 20 cases and review of the literature. J Otolaryngol Head Neck Surg. 2012;41(3):178-84.
Stelow EB, Wenig BM. Update from the 4th edition of the World Health Organization classification of head and neck tumours: carcinomas of the nasal cavity, paranasal sinuses and skull base. Head Neck Pathol. 2017;11(1):3-15.
Dey P, Das A, Sharma JD, Sharma SC. Sinonasal carcinosarcoma: a rare case report. BMJ Case Rep. 2020;13(11):e235126.
Cruz E. A rare case of invasive sinonasal carcinosarcoma. Int. J. Surg. Case Rep. 2020;70:243-8.
Alem H, Al Noury M. Management of spindle cell carcinoma of the maxillary sinus: A case report and literature review. Am J Case Rep. 2014;15:454-8.
Gore MR. Treatment, outcomes, and demographics in sinonasal sarcoma: A systematic review of the literature. BMC Ear Nose Throat Disord. 2018;18:1-13.
