Yonsei Med J.  2006 Aug;47(4):571-574. 10.3349/ymj.2006.47.4.571.

Lung Metastasis from an Immature Teratoma of the Nasal Cavity Masquerading as Small Cell Carcinoma of the Lung

• Kang MK
• Ahn YC
• Park JO
• Han J
• Lee KS

• KMID: 1779509
• DOI: http://doi.org/10.3349/ymj.2006.47.4.571

Abstract

We report a case of small cell lung cancer that turned out to be a metastatic teratoma from the nasal cavity rather than a new primary cancer. A 54-year-old woman was diagnosed with an immature teratoma of the nasal cavity with a predominant neuroblastomatous component. Small cell lung cancer was detected by bronchoscopic biopsy 21 months later, and it was treated with concurrent radiochemotherapy as if it had been a new primary cancer. Since a recurrent tumor containing fat- like density grew slowly on the serial chest CT scans after achieving complete response, we reached the conclusion that the small undifferentiated cells could be metastatic neuroblastomatous components from the immature teratoma of the nasal cavity.

Keyword

Teratoma; small cell carcinoma; metastasis

MeSH Terms

Treatment Outcome
Tomography, X-Ray Computed
Teratoma/*diagnosis/*pathology
Neoplasm Metastasis
Nasopharyngeal Neoplasms/*diagnosis/*pathology
Middle Aged
Lung Neoplasms/*diagnosis/*secondary
Humans
Female
Carcinoma, Small Cell/*diagnosis/*pathology
Bronchoscopy/methods
Biopsy

Figure

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  Fig. 1 Microscopic finding of immature teratoma of the nasal cavity: the tumor consisted of mature squamous cells with pilosebaceous differentiation (black arrow) and a neuroblastomatous component composed of compact sheets of small round cells (white arrow) with partial neuronal differentiation (H & E stain, magnification 40×).

• 

  Fig. 2 Microscopic finding of bronchoscopic biopsy shows compact sheets of small round cells with hyperchromatic nuclei, inconspicuous nucleoli associated with squeezing artifacts and a scant amount of cytoplasm, suggestive of small cell carcinoma of the lung (H & E stain, magnification 400×).

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  Fig. 3 Serial chest CT scans: (A) At the time of the small cell lung cancer diagnosis (Nov. '99); (B) Only radiation pneumonitis existed ten months after thoracic radiation therapy (Oct. '00); (C) A new mass with fat density was detected (Nov. '01); (D) A slow growing mass with fat density and another new mass replacing the right upper lobe (Oct. '03).

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