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Skull Base 2006; 16(3): 169-173
DOI: 10.1055/s-2006-939677
CASE REPORT

Copyright © 2006 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA.

Esthesioneuroblastoma (Olfactory Neuroblastoma) with Hemorrhage: An Unusual Presentation

Prakash Sampath1 , Michael C. Park1 , Dara Huang2 , Curtiland Deville2 , Selina Cortez3 , Prakash Chougule2
  • 1Department of Clinical Neurosciences Program in Neurosurgery, Division of Neuropathology, Brown Medical School, Rhode Island Hospital, Providence, Rhode Island
  • 2Department of Radiation Oncology, Division of Neuropathology, Brown Medical School, Rhode Island Hospital, Providence, Rhode Island
  • 3Department of Pathology and Laboratory Medicine, Division of Neuropathology, Brown Medical School, Rhode Island Hospital, Providence, Rhode Island
Further Information

Publication History

Publication Date:
03 May 2006 (online)

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ABSTRACT

Esthesioneuroblastoma (olfactory neuroblastoma) is an uncommon neuroectodermal tumor. Its biological activity ranges from indolent growth to local recurrence and rapid widespread metastasis. Treatment options consist of surgical resection followed by radiation therapy for primary lesions and the addition of chemotherapy for advanced, recurrent, or metastatic lesions. Patients often present with nasal obstruction, rhinorrhea, recurrent epistaxis, hyposmia, or anosmia. However, we report the highly unusual case of a patient with an esthesioneuroblastoma who presented with atypical symptoms of headaches, sinus congestion, and fatigue before acutely losing consciousness. Imaging showed a large frontal skull-based tumor associated with intratumoral hemorrhage. The findings prompted an emergent combined anterior craniofacial resection with gross total resection of the tumor. Except for anosmia, the patient recovered almost completely. Postoperatively, she received adjuvant intensity-modulated radiation therapy and chemotherapy. This is the first reported case of an esthesioneuroblastoma presenting with hemorrhage and rapidly declining mental status, an acute neurological manifestation of which clinicians should be aware.

KEYWORDS

Esthesioneuroblastoma - hemorrhage - neurological deterioration - olfactory neuroblastoma

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Prakash SampathM.D. 

Roger Williams Medical Center, 825 Chalkstone Ave.

Providence, RI 02908

Email: prakash_sampath@hotmail.com