Fine-needle aspiration of triton tumor: morphology, immunohistochemistry, electron microscopy, and cell image analysis

Prognostic factors for the malignant triton tumor of the head and neck

BACKGROUND

Malignant triton tumors are rare neoplasias consisting of a malignant peripheral nerve sheath tumor with additional rhabdomyoblastic differentiation. These tumors are highly aggressive and prognosis is poor. Our aim is to describe the outcome and to identify potential prognostic factors.

METHODS

From 1993 to 2005, 7 patients with a malignant triton tumor of the head and neck were treated at our institution. A literature search revealed another 46 published cases. All these cases were analyzed for outcome and prognostic factors.

RESULTS

Patients with primary tumors involving the nose and paranasal sinuses have better, patients involving the neck a poor prognosis. All other locations show an intermediate course. Complete surgical removal is of crucial importance. Additional radiation or chemotherapy show little effect.

CONCLUSION

Location of the primary tumor is a key factor for prognosis. Complete surgical removal is the only treatment associated with survival.

Malignant triton tumor in a patient with neurofibromatosis type 1

We report a case of neurofibromatosis type 1 (NF1) complicated by a malignant triton tumor (MTT), with an emphasis on B-mode sonographic (US) and contrast-enhanced US (CEUS) findings. To the best of our knowledge, this is the first report describing CEUS findings of MTT. The mass was poorly demarcated and composed of an internal echogenic area and an outer hypoechoic zone. CEUS findings showed the outer zone to be strongly enhanced, and the internal area was very poor in blood flow because of necrotic tissues.

Malignant triton tumor of the supraclavicular region arising after radiotherapy

Malignant triton tumor (MTT) is a relatively rare, aggressive tumor comprised of both malignant schwannoma cells and malignant rhabdomyoblasts. Only three cases of MTT which arose after radiation therapy were reported in the literature. We presented an additional case of MTT arising after radiotherapy and discussed its clinical and pathological characteristics.