Sinonasal teratocarcinosarcoma (TCS) are highly aggressive and rare malignant tumours arising from the heterogeneous admixture of components of all the three germ cell layers. There are <60 cases that have been reported in the literature. In spite of aggressive therapy, the average survival is <3 years with multimodality therapy. In total, 70% of the patients who survived >1 year received regimen of combined surgery and adjuvant therapies and this suggests that aggressive therapeutic approaches may improve the treatment outcome.

We are reporting a case study of sinonasal TCS treated with initial surgery followed with concurrent chemoradiotherapy using intensity-modulated radiotherapy (IMRT) technique. The concurrent chemotherapy and adjuvant chemotherapy consisted of carboplatin and etoposide.

This aggressive treatment protocol of concurrent chemoradiation along with adjuvant chemotherapy is well tolerated and produced 5-year locoregional control and survival without any long-term morbidities.

Our treatment protocol was well tolerated and the outcome in this individual patient has been encouraging. This could justify a combined modality approach with post-operative simultaneous-integrated boost-IMRT and chemotherapy (concurrent and adjuvant) for future patient with sinonasal TCS.