case_images: PMC10657243_01
case_images: Axial and coronal postcontrast T1-weighted with fat saturation MR images of patient no. 1 with T4bN0M0 TCS located in the right nasal cavity and paranasal sinuses with contralateral extension. Note: cranial extension through the cribriform plate with (limited) invasion of brain parenchyma. (a): prior to neoadjuvant chemotherapy; (b): after 2 cycles of carboplatin/etoposide.
case_images: CRIOT2023-4788617.001.jpg
case_images: PMC10657243_01_CRIOT2023-4788617.001.jpg
case_images: fig1
case_images: CT and MR imaging of the head and neck revealed a destructive mass laterally in the right nasal cavity and ethmoid sinus, extending caudally to the inferior nasal turbinate and posteriorly to the nasopharynx. Cranially, the tumor extended to the orbit and the anterior skull base with destruction of the cribriform plate and invasion of brain parenchyma (Figure 1).
case_images: Histopathological images of patient no. 1. (a): undifferentiated component. (b): adenocarcinoma, squamous cell carcinoma, and sarcoma components.
case_images: CRIOT2023-4788617.002.jpg
case_images: PMC10657243_01_CRIOT2023-4788617.002.jpg
case_images: fig2
case_images: Histological evaluation of the resection specimen showed a malignant neoplasm with epithelial, mesenchymal, and primitive neuroepithelial elements. (Figure 2).
case_images: PMC10657243_02
case_images: Axial and coronal postcontrast T1-weighted MR images of patient no. 2 with a T4bN0M0 tumor located in the left ethmoid sinus with gross intracranial extension. Note: extensive peritumoral (low signal intensity) edema resulting in a midline shift towards the right side.
case_images: CRIOT2023-4788617.003.jpg
case_images: PMC10657243_02_CRIOT2023-4788617.003.jpg
case_images: fig3
case_images: Subsequent CT and MR imaging of the head and neck revealed a mass in the left ethmoid sinus (Figure 3).
case_images: PMC10657243_03
case_images: Axial STIR, coronal, and axial postcontrast T1-weighted with fat saturation MR images of patient no. 3 with a T3N2bM0 tumor located in the right nasal cavity and sphenoid sinus. On the axial image, the primary tumor has an intermediate signal intensity. Note: due to obstruction by the tumor, the right maxillary sinus and the sphenoid sinus are filled with retained secretions displaying high signal intensity. The coronal image shows the enhancing tumor in the right nasal cavity just medial to the middle turbinate (arrow). Axial postcontrast image lower in the neck with a markedly enlarged lymph node in level II (fine needle aspiration cytology: TCS lymph node metastasis).
case_images: CRIOT2023-4788617.004.jpg
case_images: PMC10657243_03_CRIOT2023-4788617.004.jpg
case_images: fig4
case_images: Subsequent CT and MR imaging of the head and neck revealed a mass in the right ethmoid sinus, nasal cavity, and sphenoid sinus (Figure 4).
case_images: Histopathological images of patient no 3. Immunohistochemistry demonstrating loss of SMARCA4 expression in tumor cells of a patient with a teratocarcinosarcoma. Note: the positive internal control: expression of SMARCA4 in the superficial epithelium.
case_images: CRIOT2023-4788617.005.jpg
case_images: PMC10657243_03_CRIOT2023-4788617.005.jpg
case_images: fig5
case_images: SMARCA4 stain showed a loss of expression in tumor cells (Figure 5). SALL4 showed moderate-to-strong expression (2+ to 3+) in approximately 50% of the primitive neuroepithelial and adenocarcinoma components. ss-Catenin did not show aberrant nuclear expression.