Pathology of the Head and Neck

64 A. Cardesa · L. Alos · A. Franchi2baFig. 2.19. Teratocarcinosarcoma. a CT scan showing massive destructiveinfiltration of the nasal cavity and maxillary sinus on theleft. With permission [75] b Cystic spaces filled with mucin arepartly covered by benign columnar epithelium and surrounded bycimmature blastematous tissue. c Immature glands surrounded byblastematous elements at the lower left; presence of immature striatedmuscle, upper right and centresquamous carcinoma and others [105]. In contradistinctionto malignant gonadal teratomas, which arefrequently found in patients at a younger age, sinonasalteratocarcinosarcoma does not contain areas of embryonalcarcinoma, choriocarcinoma or germinoma (seminoma),as seen in many germ cell tumours. This makesa germ cell origin of SNTCS unlikely [112]. The histogenesisof sinonasal teratocarcinosarcoma is debatable.The presence of neural tissue in these neoplasms raisesthe possibility that the origin could be in some wayrelated to the olfactory membrane, or alternatively tothe sinonasal membrane as a whole, since the olfactorymembrane also develops from it [112].Sinonasal teratocarcinosarcomas are locally aggressivetumours, with rapid invasion of soft tissues andbone, and metastasise to regional lymph nodes andsites, such as the lung. The average survival of a patientwith SNTCS is 1.7 years, with 60% of the patientsnot surviving beyond 3 years. The treatment of SNTCSis controversial, but an aggressive initial therapeuticalapproach with a combination of surgical resection, radiotherapyand chemotherapy is usually recommended[112].References1. Abdel-Latif SM, Baheeg SS, Aglan YI, Babin RW, Giltman LI(1987) Chronic atrophic rhinitis with fetor (ozena): a histopathologictreatise. Rhinology 25:117–1202. Abemayor E, Canalis RF, Greenberg P, Wortham DG, RowlandJP, Sun NC (1988) Plasma cell tumors of the head andneck. J Otolaryngol 17:376–3813. Abbondanzo SL, Wenig BM (1995) Non-Hodgkin’s lymphomaof the sinonasal tract. A clinicopathologic and immunophenotypicstudy of 124 cases. Cancer 75:1281–12914. Acheson ED, Cowdell RH, Hadfield E, Macbeth RG (1968)Nasal cancer in woodworkers in the furniture industry. BrMed J 2:587–5965. Acheson ED, Cowdell RH, Jolles B (1970) Nasal cancer in theNorthamptonshire boot and shoe industry. Br Med J 1:385–3936. Aguilera NS, Kapadia SB, Nalesnik MA, Swerdlow SH (1995)Extramedullary plasmacytoma of the head and neck: use ofparaffin sections to assess clonality with in situ hybridization,growth fraction, and the presence of Epstein-Barr virus.Mod Pathol 8:503–5087. Aktas D, Yetiser S, Gerek M, Kurnaz A, Can C, KahramanyolM (1998) Antrochoanal polyps: analysis of 16 cases. Rhinology36:81–858. Alobid I, Alos L, Blanch JL, Benitez P, Bernal-Sprekelsen M,Mullol J (2003) Solitary fibrous tumour of the nasal cavityand paranasal sinuses. Acta Otolaryngol 123:71–749. Alos L, Cardesa A, Bombí JA, Mallofré C, Cuchi A, TraserraJ (1996) Myoepithelial tumours of salivary glands: a clinico-