Teratocarcinoma of maxillary antrum: A rare presentation of extragonadal germ cell tumor

Germ cell tumour (GCT) is a neoplasm derived from germ cells. Extra gonadal GCTs (EGGCT) are that which origin outside the gonads as a result of errors during development of embryo. The Mediastinum is the most common anatomic site for EGGCTs in adults. Maxillary GCTs are very rare and commonly occurs within the first three decades of life. Seminomatous EGGCTs variety have better prognosis than non seminomatous variety when treated with combined modality therapy (CMT). A 21 years male patient presented with left sided facial swelling of 3 months duration along with proptosis, nasal intonation of voice and difficulty in opening the mouth. On examination, a single diffuse swelling noted on the left side of the face. CECT showed left sinonasal mass extending to nasopharynx, infratemporal fossa, left orbit and also to subcutaneous plane. He was managed by left sided maxillectomy followed by adjuvant chemotherapy and radiotherapy. EGGCT mostly occours in mediastinum followed by abdomen, mostly sacrococcygeal region. EGGCTs are most common in paediatric age group (two third of GCT is extragonadal), adults and adolescents mostly suffer from gonadal GCT. In this era of combined modality management surgery combined with chemotherapy and radiotherapy gives the best outcome.