A case of recurrent malignant triton tumor successfully treated with radiotherapy

A 15-year-old female was previously admitted to another hospital because of painless swelling of the lateral right nasal ala for 2 months. Magnetic resonance imaging revealed an expansive enhancing lesion in close proximity to the anterior surface of the right maxillary sinus and lateral wall of the right nasal cavity. Tumor extirpation was performed via the supragingival transantral approach under general anesthesia. Histopathological study revealed a malignant triton tumor (MTT) arising from the nasal vestibule. The patient was referred to our department for consultation regarding additional treatment. Because the surgical margin was positive and MTT has high malignant potential, we recommended expansion re-surgical treatment following immediate free-flap reconstruction and postoperative radiotherapy, but family consent was not obtained. Tumor regrowth was noted 1 month after her first visit to our department. The patient and her family accepted radiotherapy instead of surgical treatment. Complete remission was achieved by radiotherapy alone. No local recurrence or distant metastasis was observed for 30 months after radiotherapy. The conventional mode of treatment for MTT is radical excision followed by high-dose radiotherapy. However, this case is remarkable because our patient experienced complete remission by simple radiotherapy.