Tomotherapy for sinonasal teratocarcinosarcoma with SMARCA4 deletion and CTNNB1 mutation: A case report and literature review

Sinonasal teratocarcinosarcoma (SNTCS) is a rare and aggressive malignant tumor that is difficult to diagnose and lacks a standard therapeutic strategies. Here, we report a case of SNTCS harboring a <i>SMARCA4</i> deletion and a <i>CTNNB1</i> mutation. Following incomplete surgical resection, the patient received synchronous postoperative chemotherapy with tomotherapy (TOMO) radiation and achieved a complete response lasting for > 47 months with tolerated side effects. This case suggests that <i>SMARCA4</i> deletion and <i>CTNNB1</i> mutation may be key molecular events in the development of SNTCS, potentially providing valuable clues for its diagnosis. Moreover, to the best of our knowledge, this is the first case demonstrating that TOMO technology can be a beneficial option for SNTCS radiotherapy.