True carcinosarcoma of the maxillary sinus.

A case of true carcinosarcoma primarily arising in the right maxillary sinus is reported in a 60-year-old male. His chief complaints were right nasal obstruction and bleeding. Histological findings of the biopsied primary tumor revealed two components of keratinizing squamous cell carcinoma and osteosarcoma which were intricately intermingled. Despite intensive irradiation and chemotherapy, and total maxillectomy, he finally died of rapid tumor recurrence and widely spreading metastases to lungs, pleurae and brain two months later. At autopsy the recurrent and metastatic tumors consisted entirely of the osteosarcoma component, suggesting the efficiency of the radiotherapy and chemotherapy against the carcinomatous component, but not against the sarcomatous one. As for histogenesis, this case was compatible with a combination tumor judging from histologic, immunohistochemical and electron microscopic findings.