A Unique uterine Tumor that resembles a Nasal cavity tumor!
Teratocarcinosarcoma (TCS) is a rare aggressive tumor of the nasal cavity and paranasal sinuses but here we describe a unique case of Cervical tumor that had carcinosarcomatous and teratomatous features, resembling a sinonasal TCS & is the first case report of cervical TCS. Cervical carcinosarcoma is an aggressive neoplasm with poor prognosis.

A 45-year-old woman presented to the hospital for evaluation of a cervical lesion. The gynecologist found a large polypoid mass, whose biopsy showed glandular components of probable germ cell origin. Magnetic resonance imaging revealed a mass on the cervix measuring 28 × 27 × 20 mm. The patient underwent total hysterectomy with bilateral salpingo-oophorectomy. The cervical polypoid mass was found to consist of both epithelial and mesenchymal tissues, including immature glandular structure resembling fetal enteric tubules, neuroepithelial cells, hyaline cartilage, & rhabdomyosarcoma cells. This tumor was diagnosed as TCS of the uterine cervix. Following the surgery, the patient received radiotherapy and has been free of disease for 13 months.

Points To Discuss:-
1. The present case is a unique cervical cancer, consisting of neuroepithelial components positive for CD99 and synaptophysin, immature / atypical intestinal glands positive for SALL4 and CDX-2, cartilage cells, and rhabdomyosarcoma, resembling sinonasal TCS.
2. The present case showed no HPV infection, which was confirmed by the negative reactions of immunohistochemical staining.
3. Immature / atypical intestinal glands and neuroepithelium were positive for SALL4, which is known as a sensitive and specific marker of germ cell tumors.
4. This suggests that this tumor is germ cell derived.

Source: https://diagnosticpathology.biomedcentral.com/articles/10.1186/s13000-019-0890-5
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