Sinonasal cancers are the most common malignant tumors of the anterior skull base.1 Squamous cell carcinomas, esthesioneuroblastomas, and salivary gland cancers are types most frequently encountered.2 However, rare tumors are possible, and should be recognized because many have a poor prognosis. Sinonasal teratocarcinosarcoma (SNTCS) is an exceptionally rare and highly aggressive paranasal neoplasm.