PDF herunterladen
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
Weitere Informationen

Publikationsverlauf

Publikationsdatum:
03. Mai 2006 (online)

    Lizenzen und Reprints

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

REFERENCES

  • 1 McCormack L J, Harris H E. Neurogenic tumors of the nasal fossa.  JAMA. 1955;  157 318-321
    PubMedGoogle Scholar
  • 2 Kadish S, Goodman M, Wang C C. Olfactory neuroblastoma. A clinical analysis of 17 cases.  Cancer. 1976;  37 1571-1576
    CrossrefPubMedGoogle Scholar
  • 3 Carney M E, O'Reilly R C, Sholevar B et al.. Expression of the human Achaete-scute 1 gene in olfactory neuroblastoma (esthesioneuroblastoma).  J Neurooncol. 1995;  26 35-43
    CrossrefPubMedGoogle Scholar
  • 4 Spiro J D, Soo K C, Spiro R H. Nonsquamous cell malignant neoplasms of the nasal cavities and paranasal sinuses.  Head Neck. 1995;  17 114-118
    CrossrefPubMedGoogle Scholar
  • 5 Dulguerov P, Allal A S, Calcaterra T C. Esthesioneuroblastoma: a meta-analysis and review.  Lancet Oncol. 2001;  2 683-690
    CrossrefPubMedGoogle Scholar
  • 6 O'Connor T A, Mclean P, Juillard G JK, Parker R G. Olfactory neuroblastoma.  Cancer. 1989;  63 2426-2428
    PubMedGoogle Scholar
  • 7 Broich G, Pagliari A, Ottaviani F. Esthesioneuroblastoma: a general review of the cases published since the discovery of the tumour in 1924.  Anticancer Res. 1997;  17 2683-2706
    PubMedGoogle Scholar
  • 8 Berger L, Luc Richard. L'esthesioneuroepitheliome olfactif.  Bull Assoc Fr Etude Cancer. 1924;  13 410-421
    PubMedGoogle Scholar
  • 9 Cantrell R W, Ghorayeb B Y, Fitz-Hugh G S. Esthesioneuroblastoma: diagnosis and treatment.  Ann Otol Rhinol Laryngol. 1977;  86 760-765
    PubMedGoogle Scholar
  • 10 Schmidt J L, Zarbo R J, Clark J L. Olfactory neuroblastoma: clinicopathologic and immunohistochemical characterization of four representative cases.  Laryngoscope. 1990;  100 1052-1058
    CrossrefPubMedGoogle Scholar
  • 11 Bradley P J, Jones N S, Robertson I. Diagnosis and management of esthesioneuroblastoma.  Curr Opin Otolaryngol Head Neck Surg. 2003;  11 112-118
    CrossrefPubMedGoogle Scholar
  • 12 Palacios E, Valvassori G. Olfactory esthesioneuroblastoma (olfactory neuroblastoma/olfactory neuroepithelioma).  Ear Nose Throat J. 1998;  77 890-891
    PubMedGoogle Scholar
  • 13 Elkon D, Hightower S I, Lim M L, Cantrell R W, Constable W C. Esthesioneuroblastoma.  Cancer. 1979;  44 1087-1094
    CrossrefPubMedGoogle Scholar
  • 14 Dulguerov P, Calcaterra T. Esthesioneuroblastoma: the UCLA experience 1970-1990.  Laryngoscope. 1992;  102 843-849
    CrossrefPubMedGoogle Scholar
  • 15 Levine P A, Gallagher R, Cantrell R W. Esthesioneuroblastoma: reflections of a 21-year experience.  Laryngoscope. 1999;  109 1539-1543
    CrossrefPubMedGoogle Scholar
  • 16 Resto V A, Eisele D W, Forastiere A, Zahurak M, Lee D J, Westra W H. Esthesioneuroblastoma: the Johns Hopkins experience.  Head Neck. 2000;  22 550-558
    CrossrefPubMedGoogle Scholar
  • 17 Sheehan J M, Sheehan J P, Jane Sr J A, Polin R S. Chemotherapy for esthesioneuroblastomas.  Neurosurg Clin N Am. 2000;  11 693-701
    PubMedGoogle Scholar
  • 18 Dias F L, Sa G M, Lima R A et al.. Patterns of failure and outcome in esthesioneuroblastoma.  Arch Otolaryngol Head Neck Surg. 2003;  129 1186-1192
    CrossrefPubMedGoogle Scholar
  • 19 Constantinidis J, Steinhart H, Koch M et al.. Olfactory neuroblastoma: the University of Erlangen-Nuremberg experience 1975-2000.  Otolaryngol Head Neck Surg. 2004;  130 567-574
    CrossrefPubMedGoogle Scholar

Prakash SampathM.D. 

Roger Williams Medical Center, 825 Chalkstone Ave.

Providence, RI 02908

eMail: prakash_sampath@hotmail.com