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Mays AC, Bell D, Ferrarotto R, Phan J, Roberts D, Fuller CD, Frank SJ, Raza SM, Kupferman ME, DeMonte F, Hanna EY, Su SY. Early Stage olfactory neuroblastoma and the impact of resecting dura and olfactory bulb. Laryngoscope 2017; 128:1274-1280. [PMID: 29226334 DOI: 10.1002/lary.26908] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/15/2017] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Compare outcomes of patients with olfactory neuroblastoma (ONB) without skull base involvement treated with and without resection of the dura and olfactory bulb. METHODS Retrospective review of ONB patients treated from 1992 to 2013 at the MD Anderson Cancer Center (The University of Texas, Houston, Texas, U.S.A.). Primary outcomes were overall and disease-free survival. RESULTS Thirty-five patients were identified. Most patients had Kadish A/B. tumors (97%), Hyams grade 2 (70%), with unilateral involvement (91%), and arising from the nasal cavity (68%). Tumor involved the mucosa abutting the skull base in 42% of patients. Twenty-five patients (71%) received surgery and radiation, whereas the remainder had surgery alone. Five patients (14%) had bony skull base resection, and eight patients (23%) had resection of bony skull base, dura, and olfactory bulb. Surgical margins were grossly positive in one patient (3%) and microscopically positive in four patients (12%). The 5- and 10-year overall survival were 93% and 81%, respectively. The 5- and 10-year disease-free survival (DFS) were 89% and 78%, respectively. Bony cribriform plate resection was associated with better DFS (P = 0.05), but dura and olfactory bulb resection was not (P = 0.11). There was a trend toward improved DFS in patients with negative resection margins (P = 0.19). Surgical modality (open vs. endoscopic) and postoperative radiotherapy did not impact DFS. CONCLUSION Most Kadish A/B ONB tumors have low Hyams grade, unilateral involvement, and favorable survival outcomes. Resection of the dura and olfactory bulb is not oncologically advantageous in patients without skull base involvement who are surgically treated with negative resection margins and cribriform resection. LEVEL OF EVIDENCE 4. Laryngoscope, 128:1274-1280, 2018.
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Affiliation(s)
- Ashley C Mays
- Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas, U.S.A
| | - Diana Bell
- Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, Texas, U.S.A
| | - Renata Ferrarotto
- Department of Thoracic Head and Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, U.S.A
| | - Jack Phan
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, U.S.A
| | - Dianna Roberts
- Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas, U.S.A
| | - Clifton D Fuller
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, U.S.A
| | - Steven J Frank
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, U.S.A
| | - Shaan M Raza
- Department of Neurosurgery, The University of Texas MD Anderson Cancer Center, Houston, Texas, U.S.A
| | - Michael E Kupferman
- Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas, U.S.A
| | - Franco DeMonte
- Department of Neurosurgery, The University of Texas MD Anderson Cancer Center, Houston, Texas, U.S.A
| | - Ehab Y Hanna
- Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas, U.S.A
| | - Shirley Y Su
- Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas, U.S.A
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Wadhwani M, Ranjan A, Gangwani K, Das P. An Unusual Presentation of Esthesioneuroblastoma in a Young Pregnant Female. Ocul Oncol Pathol 2017; 4:192-195. [PMID: 29765954 DOI: 10.1159/000481507] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2017] [Revised: 09/13/2017] [Indexed: 11/19/2022] Open
Abstract
Background Esthesioneuroblastoma is a rare neuroepithelial tumor arising from the olfactory epithelium in the cribriform plate or nasal cavity. It accounts for 1-5% of cases of malignant neoplasms of the nasal cavity. Methods A 20-year-old pregnant female presented with painful loss of vision in both eyes, on imaging diagnosed as meningioma. There was a progressive increase in pain along with diminution of vision to the extent of complete loss of vision in the right eye. Results In view of increasing proptosis with progressive complete loss of vision in the left eye also, she consulted the neurosurgery department at a tertiary care hospital where a follow-up of contrast-enhanced computerised tomography was made. Histopathology of fluid obtained after craniotomy showed esthesioneuroblastoma. In view of intracranial space-occupying lesion applying pressure on the optic nerve, intravenous methylprednisolone (1 g, IV stat X 3 days) was given. She underwent extensive radiotherapy but died within 3 months of diagnosis. Conclusion This case highlights the progressive and fatal course of olfactory neuroblastoma. As it can present with the complex symptoms related to ocular and nasal sites, timely referral of patients presenting with visual symptoms along with nasal involvement (frequent epistaxis) to otorhinolaryngologists is very important.
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Affiliation(s)
| | - Amar Ranjan
- Dr B.R. Ambedkar Institute Rotary Cancer Hospital, New Delhi, India
| | | | - Prasenjit Das
- Department of Pathology, All India Institute of Medical Sciences, New Delhi, India
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Gumpel E, Moore AS, Simpson DJ, Hoffmann KL, Taylor DP. Long-term control of olfactory neuroblastoma in a dog treated with surgery and radiation therapy. Aust Vet J 2017; 95:227-231. [PMID: 28653386 DOI: 10.1111/avj.12602] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2016] [Revised: 10/05/2016] [Accepted: 10/14/2016] [Indexed: 11/29/2022]
Abstract
BACKGROUND Olfactory neuroblastoma is a rare malignancy of the nasal cavity in dogs that is thought to arise from specialised sensory neuroendocrine olfactory cells derived from the neural crest. CASE REPORT An 8-year-old dog was presented for reclusiveness and pacing. On CT and MRI, a contract-enhancing mass was disclosed within the rostral fossa, extending caudally from the cribriform plate into the left nasal sinus. Surgical excision was performed and the diagnosis was histological grade III (Hyams grading scheme) olfactory neuroblastoma. Based on human CT criteria this was high stage (modified Kadish stage C). Surgical excision was incomplete and was followed by curative-intent radiation therapy using a linear accelerator to a total dose of 48 Gy. CONCLUSION The dog survived 20 months after diagnosis. Although olfactory neuroblastoma is a rare tumour in dogs, aggressive local therapy may allow for prolonged survival, even when the tumour is advanced.
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Affiliation(s)
- E Gumpel
- Brisbane Veterinary Specialist Centre, Albany Creek, Queensland, Australia
| | - A S Moore
- Animal Referral Hospital, Homebush, New South Wales, Australia.,Veterinary Oncology Consultants, Wauchope, New South Wales, Australia
| | - D J Simpson
- Animal Referral Hospital, Homebush, New South Wales, Australia
| | - K L Hoffmann
- Animal Referral Hospital, Homebush, New South Wales, Australia.,Imaging Vets, Putney, New South Wales, Australia
| | - D P Taylor
- Vetnostics, North Ryde, New South Wales, Australia
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Woods RSR, Subramaniam T, Leader M, McConn-Walsh R, O'Neill JP, Lacy PD. Changing Trends in the Management of Esthesioneuroblastoma: Irish and International Perspectives. J Neurol Surg B Skull Base 2017; 79:262-268. [PMID: 29765824 DOI: 10.1055/s-0037-1607298] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2017] [Accepted: 09/05/2017] [Indexed: 10/18/2022] Open
Abstract
Objectives Evaluation of the changing trends in esthesioneuroblastoma in an Irish context and review of management options nationally to clarify the best current therapeutic approach by comparing with international research on this uncommon malignancy. Design Retrospective review. Setting Tertiary referral center. Participants All patients presenting with esthesioneuroblastoma in Beaumont hospital or on the National Cancer Registry of Ireland between 1994 and 2013. Main Outcome Measures Recurrence-free and overall survival. Results During the study period, 32 cases of esthesioneuroblastoma were diagnosed (0.4 per million per year). Average age at diagnosis was 57 years; however, two cases were under 20. The majority (62.5%) were male. Patients predominantly presented with epistaxis or nasal congestion (73%), while two cases were identified incidentally on radiological investigations. Twenty-seven cases underwent primary surgical management (two post neo-adjuvant treatment) with seventeen requiring bifrontal craniotomy. Twenty-four of these received postoperative radiation therapy. Overall, 5-year survival was 65%. Kadish A/B patients exhibited 100% 5-year disease-specific survival versus 54% in Kadish C/D ( p = 0.011). Hyams grade I/II patients exhibited 75% 5-year disease-specific survival versus 63% in Hyams grade III/IV ( p = 0.005). Patients treated endoscopically exhibited 100% 5-year disease-specific survival versus 51% in those treated via an open approach ( p = 0.102). Conclusions Many controversies exist in the diagnosis and management of this condition. Despite this, results from Irish data are mostly concordant with the international literature. The rising incidence of this disease may represent improved pathological recognition. An increasing number of esthesioneuroblastoma cases are being successfully treated via endoscopic surgery.
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Affiliation(s)
| | | | - Mary Leader
- Department of Histopathology, Beaumont Hospital, Dublin 9, Ireland
| | | | | | - Peter D Lacy
- Department of ENT Surgery, Beaumont Hospital, Dublin 9, Ireland
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105
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Desai DD, Brandon BM, Perkins EL, Ebert CS, Zanation AM, Thorp BD. Staging of Sinonasal and Ventral Skull Base Malignancies. Otolaryngol Clin North Am 2017; 50:257-271. [PMID: 28314399 DOI: 10.1016/j.otc.2016.12.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Tremendous pathologic diversity among sinonasal and ventral skull base malignancies complicates development of a uniform and prognostically relevant staging system. Because of the comparatively low incidence of these tumors, comprehensive evaluation and comparison of specific staging systems is difficult. The current American Joint Committee on Cancer TNM staging system for sinonasal malignancies is the most common and widely used system in current clinical practice. Alternative systems have been proposed for use with individual histopathologic subtypes. Many of these staging systems are of great utility and accurately predict patient survival. Further research and adjustment of these current staging systems remains an important area of research.
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Affiliation(s)
- Dipan D Desai
- Department of Otolaryngology/Head and Neck Surgery, 170 Manning Drive, CB 7070, Chapel Hill, NC 27599, USA
| | - Bryan M Brandon
- Department of Otolaryngology/Head and Neck Surgery, 170 Manning Drive, CB 7070, Chapel Hill, NC 27599, USA
| | - Elizabeth L Perkins
- Department of Otolaryngology/Head and Neck Surgery, 170 Manning Drive, CB 7070, Chapel Hill, NC 27599, USA
| | - Charles S Ebert
- Department of Otolaryngology/Head and Neck Surgery, 170 Manning Drive, CB 7070, Chapel Hill, NC 27599, USA
| | - Adam M Zanation
- Department of Otolaryngology/Head and Neck Surgery, 170 Manning Drive, CB 7070, Chapel Hill, NC 27599, USA; Department of Neurosurgery, 170 Manning Drive, CB 7060, Chapel Hill, NC 27599, USA
| | - Brian D Thorp
- Department of Otolaryngology/Head and Neck Surgery, 170 Manning Drive, CB 7070, Chapel Hill, NC 27599, USA.
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106
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Wertz A, Hollon T, Marentette LJ, Sullivan SE, McHugh JB, McKean EL. Surgical Treatment of Olfactory Neuroblastoma: Major Complication Rates, Progression Free and Overall Survival. J Neurol Surg B Skull Base 2017; 79:151-155. [PMID: 29868319 DOI: 10.1055/s-0037-1605593] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2016] [Accepted: 06/21/2017] [Indexed: 10/19/2022] Open
Abstract
Objective We aimed to compare major complication rates in patients undergoing open versus endoscopic resection of olfactory neuroblastoma (ONB) and to determine the prognostic utility of the Kadish staging and Hyams grading systems with respect to progression-free survival (PFS) and overall survival (OS). Methods It is a retrospective review of experience in treating ONB at a single tertiary care hospital from 1987 through 2015. Major complications were defined as cerebrospinal fluid (CSF) leak, meningitis, osteomyelitis, tracheostomy, and severe neurologic injury. Results Forty-one patients were included. An open approach was used in 34 (83%), endoscopic in 6 (15%), and combined in 1 (2%) case. Rates of major complications by surgical approach were 17% after endoscopic versus 31% after open ( p = 0.65). There was no significant difference in PFS or OS based on Kadish B versus C (PFS, p = 0.28; OS, p = 0.11) or Hyams grade 1 and 2 versus Hyams grade 3 and 4 (PFS, p = 0.53; OS, p = 0.38). Conclusions There was no significant difference in major complications between open and endoscopic approaches for the treatment of ONB. Patient stratification using the Kadish staging and Hyams grading systems did not show significant differences in PFS or OS. Further research is needed to determine if a different staging system would better predict patient outcomes.
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Affiliation(s)
- Aileen Wertz
- Department of Otolaryngology - Head and Neck Surgery, University of Michigan Health System, Ann Arbor, Michigan, United States
| | - Todd Hollon
- Department of Neurosurgery, University of Michigan Health System, Ann Arbor, Michigan, United States
| | - Lawrence J Marentette
- Department of Otolaryngology - Head and Neck Surgery, University of Michigan Health System, Ann Arbor, Michigan, United States.,Department of Neurosurgery, University of Michigan Health System, Ann Arbor, Michigan, United States.,Section of Oral and Maxillofacial Surgery, Department of Surgery, University of Michigan Health System, Ann Arbor, Michigan, United States
| | - Stephen E Sullivan
- Department of Neurosurgery, University of Michigan Health System, Ann Arbor, Michigan, United States
| | - Jonathan B McHugh
- Department of Pathology, University of Michigan Health System, Ann Arbor, Michigan, United States
| | - Erin L McKean
- Department of Otolaryngology - Head and Neck Surgery, University of Michigan Health System, Ann Arbor, Michigan, United States.,Department of Neurosurgery, University of Michigan Health System, Ann Arbor, Michigan, United States
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107
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Konuthula N, Iloreta AM, Miles B, Rhome R, Ozbek U, Genden EM, Posner M, Misiukiewicz K, Govindaraj S, Shrivastava R, Gupta V, Bakst RL. Prognostic significance of Kadish staging in esthesioneuroblastoma: An analysis of the National Cancer Database. Head Neck 2017; 39:1962-1968. [PMID: 28815831 DOI: 10.1002/hed.24770] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2016] [Revised: 10/27/2016] [Accepted: 02/10/2017] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Given the rarity of esthesioneuroblastoma, it is difficult to validate a staging system. The purpose of this study was to investigate the utility of the Kadish staging system in esthesioneuroblastoma using the National Cancer Database (NCDB). METHODS One thousand one hundred sixty-seven patients with esthesioneuroblastoma were identified from the NCDB. RESULTS Five-year survival was 80.0% for Kadish A, 87.7% for Kadish B, 77.0% for Kadish C, and 49.5% for Kadish D. Kadish B had higher survival than Kadish A. More Kadish B patients received surgery with adjuvant therapy than Kadish A patients (41.6% vs 32.5%; P = .0038) and also had more positive margins (21.6% vs 11.3%; P = .03). There was no difference in age distribution, sex, race, or neck dissection status between the 2 groups. CONCLUSION Kadish B had greater survival than Kadish A, but the treatment characteristics could not account for this difference. The utility of early-stage Kadish staging is uncertain and requires further study.
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Affiliation(s)
- Neeraja Konuthula
- Department of Otolaryngology - Head and Neck Surgery, Mount Sinai Medical Center, New York, New York
| | - Alfred M Iloreta
- Department of Otolaryngology - Head and Neck Surgery, Mount Sinai Medical Center, New York, New York
| | - Brett Miles
- Department of Otolaryngology - Head and Neck Surgery, Mount Sinai Medical Center, New York, New York
| | - Ryan Rhome
- Department of Radiation Oncology, Mount Sinai Medical Center, New York, New York
| | - Umut Ozbek
- Department of Population Health Science and Policy, Mount Sinai Medical Center, New York, New York
| | - Eric M Genden
- Department of Otolaryngology - Head and Neck Surgery, Mount Sinai Medical Center, New York, New York
| | - Marshall Posner
- Department of Medicine, Hematology and Medical Oncology, Mount Sinai Medical Center, New York, New York
| | - Krzysztof Misiukiewicz
- Department of Medicine, Hematology and Medical Oncology, Mount Sinai Medical Center, New York, New York
| | - Satish Govindaraj
- Department of Otolaryngology - Head and Neck Surgery, Mount Sinai Medical Center, New York, New York
| | - Raj Shrivastava
- Department of Neurosurgery, Mount Sinai Medical Center, New York, New York
| | - Vishal Gupta
- Department of Radiation Oncology, Mount Sinai Medical Center, New York, New York
| | - Richard L Bakst
- Department of Radiation Oncology, Mount Sinai Medical Center, New York, New York
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108
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Kunimatsu A, Kunimatsu N. Skull Base Tumors and Tumor-Like Lesions: A Pictorial Review. Pol J Radiol 2017; 82:398-409. [PMID: 28811848 PMCID: PMC5540006 DOI: 10.12659/pjr.901937] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2016] [Accepted: 11/02/2016] [Indexed: 12/27/2022] Open
Abstract
A number of tumors and tumor-like non-neoplastic lesions with different cell types on histology occur in the skull base. A wide variety in disease and lesion appearance often complicates the process of radiological diagnosis. The main role of radiographic imaging is the detection and characterization of skull base lesions, with evaluation of the extent of invasion or preservation of adjacent critical organs. Evaluation of the skull base anatomy and surgical planning by using image guidance are also important for surgeons. Computed tomography (CT) and magnetic resonance (MR) imaging are the preferred modalities for the evaluation of skull base lesions. CT and MR are used for lesion detection, tissue characterization and assessment of neurovascular and bone involvement by the lesions. Both modalities provide useful information, one sometimes of greater value than the other. T1-weighted MR imaging is useful in detecting skull base lesions, typically surrounded by abundant fatty bone marrow. T2-weighted MR imaging is generally useful for tumor tissue characterization. CT surpasses MR imaging in evaluating intratumoral calcification and bone destruction or hyperostosis. To date, imaging features have been well-reported in individual skull base tumors; however, correct diagnosis by imaging alone still presents a challenge. Knowledge of clinical issues and awareness of variants of skull base tumors are of help in making a diagnosis. The purpose of this article is to review pertinent clinical issues, typical imaging appearances and certain imaging variations of common skull base lesions.
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Affiliation(s)
- Akira Kunimatsu
- Department of Radiology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Natsuko Kunimatsu
- Department of Radiology, Mita Hospital, International University of Health and Welfare, Tokyo, Japan
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109
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López F, Grau JJ, Medina JA, Alobid I. Consenso español para el tratamiento de los tumores nasosinusales. ACTA OTORRINOLARINGOLOGICA ESPANOLA 2017; 68:226-234. [DOI: 10.1016/j.otorri.2016.07.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2016] [Revised: 07/22/2016] [Accepted: 07/27/2016] [Indexed: 12/25/2022]
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111
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Gandhoke CS, Dewan A, Gupta D, Syal SK, Jagetia A, Saran RK, Meher R, Srivastava AK, Singh D. A rare case report of mixed olfactory neuroblastoma: Carcinoma with review of literature. Surg Neurol Int 2017; 8:83. [PMID: 28607817 PMCID: PMC5461572 DOI: 10.4103/sni.sni_30_17] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2017] [Accepted: 03/17/2017] [Indexed: 11/28/2022] Open
Abstract
Background: Olfactory neuroblastoma (ONB) is a rare malignant neuroectodermal tumor of the nasal cavity. Mixed olfactory neuroblastoma which contains areas of divergent differentiation is even rare. Till date, only 4 cases of mixed olfactory neuroblastomas have been reported. Case Description: We report the case of a 46-year-old male who presented with the chief complaints of nasal bleeding and nasal obstruction since 4 months. Radiological imaging was suggestive of a large heterogeneous mass in the left superior nasal cavity with extensions into bilateral maxillary, ethmoidal, and sphenoidal sinuses, as well as into the anterior cranial fossa. Bifrontal osteoplastic craniotomy and excision of the intracranial part of the tumor from above and transnasal endoscopic removal of the mass in the nasal cavities and paranasal sinuses from below was done. Postoperative radiological imaging was suggestive of gross complete excision of the mass. Histopathological diagnosis was “mixed olfactory neuroblastoma-carcinoma (squamous and glandular differentiation) Hyams grade IV.” On immunohistochemistry, the tumor cells were positive for neuron specific enolase (NSE), synaptophysin, chromogranin, and CD56 and peripherally for S100. Because of personal reasons, the patient did not take adjuvant radiotherapy. He presented again after 2 months with a full blown recurrence of esthesioneuroblastoma with similar extensions as before. The patient is now planned for salvage surgery followed by adjuvant chemoradiation. Conclusion: We report the 5th case in the world of mixed olfactory neuroblastoma-carcinoma with squamous and glandular differentiation. From an analysis of the findings in the 5 reported cases of mixed olfactory neuroblastomas, one might infer that a separate subcategory of ONB, i.e., mixed ONB, should be considered because mixed ONBs have an aggressive behavior, high rates of recurrence, and these tumors should be treated aggressively by multimodality treatment.
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Affiliation(s)
- Charandeep S Gandhoke
- Department of Neurosurgery, Maulana Azad Medical College, Lok Nayak Jai Prakash Narayan Hospital, Guru Nanak Eye Centre and G. B. Pant Institute of Postgraduate Medical Education and Research (G.I.P.M.E.R.), New Delhi, India
| | - Aditi Dewan
- Department of Pathology, Maulana Azad Medical College, Lok Nayak Jai Prakash Narayan Hospital, Guru Nanak Eye Centre and G. B. Pant Institute of Postgraduate Medical Education and Research (G.I.P.M.E.R.), New Delhi, India
| | - Divya Gupta
- Department of ENT, Maulana Azad Medical College, Lok Nayak Jai Prakash Narayan Hospital, Guru Nanak Eye Centre and G. B. Pant Institute of Postgraduate Medical Education and Research (G.I.P.M.E.R.), New Delhi, India
| | - Simran K Syal
- Department of Paediatrics, Sri Guru Ram Das Institute of Medical Sciences and Research, Amritsar, Punjab, India
| | - Anita Jagetia
- Department of Neurosurgery, Maulana Azad Medical College, Lok Nayak Jai Prakash Narayan Hospital, Guru Nanak Eye Centre and G. B. Pant Institute of Postgraduate Medical Education and Research (G.I.P.M.E.R.), New Delhi, India
| | - Ravindra K Saran
- Department of Pathology, Maulana Azad Medical College, Lok Nayak Jai Prakash Narayan Hospital, Guru Nanak Eye Centre and G. B. Pant Institute of Postgraduate Medical Education and Research (G.I.P.M.E.R.), New Delhi, India
| | - Ravi Meher
- Department of ENT, Maulana Azad Medical College, Lok Nayak Jai Prakash Narayan Hospital, Guru Nanak Eye Centre and G. B. Pant Institute of Postgraduate Medical Education and Research (G.I.P.M.E.R.), New Delhi, India
| | - Arvind K Srivastava
- Department of Neurosurgery, Maulana Azad Medical College, Lok Nayak Jai Prakash Narayan Hospital, Guru Nanak Eye Centre and G. B. Pant Institute of Postgraduate Medical Education and Research (G.I.P.M.E.R.), New Delhi, India
| | - Daljit Singh
- Department of Neurosurgery, Maulana Azad Medical College, Lok Nayak Jai Prakash Narayan Hospital, Guru Nanak Eye Centre and G. B. Pant Institute of Postgraduate Medical Education and Research (G.I.P.M.E.R.), New Delhi, India
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112
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Olfactory neuroblastoma: a single-center experience. Neurosurg Rev 2017; 41:323-331. [PMID: 28540633 DOI: 10.1007/s10143-017-0859-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2017] [Revised: 05/03/2017] [Accepted: 05/05/2017] [Indexed: 12/21/2022]
Abstract
Olfactory neuroblastoma (ONB) is a potentially curable disease, despite being an aggressive malignancy with a poor natural history. Our goal was to evaluate management outcomes for patients with ONB treated at our institution. Our prospective database for brain tumors and the pathology registry of head and neck cancers at Oslo University Hospital were searched to identify all patients treated for ONB between 1998 and 2016. Variables extracted from these databases, supplemented by retrospective chart reviews, underwent thorough analysis. All cases were formally re-examined by a dedicated head and neck pathologist. Twenty patients were identified. Follow-up was 100%. Mean follow-up was 81.5 months for the entire cohort and 120.3 months for patients with no evidence of disease. Fourteen patients underwent treatment of choice including craniofacial resection (CFR) with or without radiotherapy (XRT). Six patients could only receive less extensive treatment; three patients underwent lateral rhinotomy (LR) with or without XRT after being deemed medically unsuitable for CFR, while another three patients received only supportive, non-surgical treatment (due to positive lymph node status in two and to extensive tumor size in one case). Overall and disease-specific survival rates were 100% after 10 years of follow-up when negative surgical margins were achieved by CFR. Positive margins were associated with poorer outcome with no patients surviving longer than 44 months. Long-term survival was also achieved in two cases among patients not eligible for CFR: one case after radical LR and one case after radio-chemotherapy. Advanced disease at presentation (tumor size ≥40 mm, Kadish grades C and D, or TNM IVa and IVb) and positive surgical margins were correlated to significantly dismal survival. Our study suggests that CFR with or without adjuvant XRT is safe and leads to excellent long-time overall and disease-specific survival. Negative surgical margins, tumor size <40 mm, Kadish stage A/B, and TNM stages I-III are independent prognostic predictors of outcome.
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113
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New tumor entities in the 4th edition of the World Health Organization classification of head and neck tumors: Nasal cavity, paranasal sinuses and skull base. Virchows Arch 2017; 472:315-330. [DOI: 10.1007/s00428-017-2116-0] [Citation(s) in RCA: 58] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2017] [Accepted: 03/31/2017] [Indexed: 10/19/2022]
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114
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Ishii M, Bishop JA, Gallia GL. Assessment of frozen section margin analysis during olfactory neuroblastoma surgery. Laryngoscope 2017; 127:1735-1741. [PMID: 28349538 DOI: 10.1002/lary.26496] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2016] [Revised: 12/07/2016] [Accepted: 12/23/2016] [Indexed: 11/06/2022]
Abstract
OBJECTIVES 1) assess the performance of the intraoperative frozen section procedure to correctly classify biopsies obtained during olfactory neuroblastoma (ONB) surgery; 2) define the relationship between posttest probabilities and pretest probabilities from frozen section analysis; and 3) review incorrectly classified specimens. STUDY DESIGN Study of diagnostic accuracy. METHODS We searched our institution's pathology database for patients who had ONB surgery between January 1, 2000 and November 16, 2012. We only included patients who had a definitive diagnosis of ONB prior to surgery and frozen sections obtained during surgery. All frozen sections in this study had corresponding permanent sections available to serve as a gold standard. This database was analyzed to obtain classification statistics. The confidence intervals for classification performance were obtained using the bootstrap sampling method. Confidence intervals for posttest probability curves were derived using the Taylor series expansion. Finally, we obtained and reviewed the slides from ambiguous or incorrect reads. RESULTS A total of 459 specimens from 33 patients were analyzed. We found the following performance characteristics: sensitivity: 0.89 (0.81, 0.94); specificity: 0.96 (0.94, 0.98); accuracy: 0.95 (0.92, 0.96); likelihood ratio positive: 24.4 (14.5, 44.1); prevalence: 0.20 (0.17, 0.25); positive predictive value: 0.86 (0.78, 0.92); and negative predictive value: 0.97 (0.95, 0.99). Histopathologic review revealed that crush artifacts and inadequate specimen size were major sources of incorrect reads. CONCLUSION We found frozen section assessment of ONB specimens to be an excellent tool for the assessment of intraoperative margins. LEVEL OF EVIDENCE NA. Laryngoscope, 127:1735-1741, 2017.
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Affiliation(s)
- Masaru Ishii
- Department of Otolaryngology-Head and Neck Surgery and Neurosurgery, Johns Hopkins University, Baltimore, Maryland, U.S.A
| | - Justin A Bishop
- Department of Pathology, Johns Hopkins University, Baltimore, Maryland, U.S.A
| | - Gary L Gallia
- Department of Otolaryngology-Head and Neck Surgery and Neurosurgery, Johns Hopkins University, Baltimore, Maryland, U.S.A
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Olfactory neuroblastoma: 14-year experience at an Australian tertiary centre and the role for longer-term surveillance. The Journal of Laryngology & Otology 2016; 131:S29-S34. [PMID: 27917732 DOI: 10.1017/s0022215116009592] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
BACKGROUND Olfactory neuroblastoma is a rare sinonasal malignancy, with poorly defined treatment protocols. Management at a tertiary centre was retrospectively evaluated to inform future treatment and follow up. METHODS Cases treated with curative intent (2000-2014) were included. Data were collected, and overall and disease-free survival rates were calculated. RESULTS Eleven cases were identified, with a median follow up of 87 months. One patient was Kadish stage A, one was stage B, eight were stage C and one was stage D. The latter patient underwent chemoradiotherapy alone. The remaining patients proceeded to: endoscopic-assisted wide local excision (n = 2), anterior craniofacial resection (n = 4) or endoscopic craniofacial resection (n = 4). No patients had primary nodal disease or elective neck treatment. One patient had neoadjuvant chemoradiation. Six patients had post-operative radiotherapy; three received adjuvant chemotherapy. Two patients had late cervical node failure, and proceeded to neck dissection and post-operative radiotherapy. Two patients had late local recurrence. Ten-year overall and disease-free survival rates were 68.2 and 46.7 per cent, respectively. CONCLUSION Longer-term follow up is supported given the incidence of late regional and local recurrence. Prophylactic treatment of cervical nodes in locally advanced disease is an area for further investigation.
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Zhang L, Niu K, Zhu K, Xia C, Yan J, Zhao W, Wei J, Duan M, Zheng G. Long-Term Prognostic Analysis after Endoscopic Endonasal Surgery for Olfactory Neuroblastoma: A Retrospective Study of 13 Cases. PLoS One 2016; 11:e0166046. [PMID: 27806104 PMCID: PMC5091887 DOI: 10.1371/journal.pone.0166046] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2016] [Accepted: 10/21/2016] [Indexed: 11/23/2022] Open
Abstract
Objectives To summarize the characteristics and long–term outcomes of olfactory neuroblastoma through the analysis of 13 cases in single institution, with the assessment of treatment modality, prognostic factors. Method A retrospective study of thirteen cases diagnosed as olfactory neuroblastoma and underwent combined treatments during the period 2000–2010. Statistical analysis was performed to search for prognostic factors and compared different treatment modalities. Results 13 patients were enrolled in this study, including 8 male and 5 female, ranging from 15 to 69 (median 43) years old. One patient at stage A was only treated with endoscopic endonasal surgery (EES). Seven patients were treated with preoperative radiotherapy and EES, two with EES and postoperative radiotherapy, and the other three with combined radiotherapy and chemotherapy. The range of follow-up time varied from 23 to 116 months (median 65 months). The 5-year overall survival rate was 46.2% (6/13). To date, these thirteen patients have not suffered local recurrences while two patients had lymph node recurrences and one had distant metastasis in the bone marrow. In 13 patients, 61.5% were diagnosed as late T stage (T3/4), 69.2% late Kadish stage (C/D) and 53.8% were high Hyams grade (I/ II), which indicated poor prognosis. Related prognostic factors were the TNM stage (T stage P = 0.028, N stage P = 0.000, M stage P = 0.007), Kadish stage (P = 0.025) and treatment modality (P = 0.015). Conclusion Late stage of TNM and Kadish staging system indicated a poor prognosis. Combined treatment modality, including endoscopic endonasal surgery, achieved a better outcome than non-surgical approach.
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Affiliation(s)
- Luyao Zhang
- Department of Otorhinolaryngology Head and Neck Surgery, the Second Affiliated Hospital of Xi'an Jiaotong University, Xi’an, Shaanxi, China
| | - Kai Niu
- Department of Clinical Science, Technology and Intervention, Karolinska Institutet, Karolinska Hospital, Stockholm, Sweden
- Department of Otorhinolaryngology Head and Neck Surgery, the No.1 Affiliated Hospital of Jilin University, Changchun, Jilin, China
| | - Kang Zhu
- Department of Otorhinolaryngology Head and Neck Surgery, the Second Affiliated Hospital of Xi'an Jiaotong University, Xi’an, Shaanxi, China
| | - Cui Xia
- Department of Otorhinolaryngology Head and Neck Surgery, the Second Affiliated Hospital of Xi'an Jiaotong University, Xi’an, Shaanxi, China
| | - Jing Yan
- Department of Otorhinolaryngology Head and Neck Surgery, the Second Affiliated Hospital of Xi'an Jiaotong University, Xi’an, Shaanxi, China
| | - Wei Zhao
- Department of Otorhinolaryngology, Shangluo Central Hospital, Shangluo, Shaanxi, China
| | - Junrong Wei
- Department of Otorhinolaryngology Head and Neck Surgery, the Second Affiliated Hospital of Xi'an Jiaotong University, Xi’an, Shaanxi, China
| | - Maoli Duan
- Department of Clinical Science, Technology and Intervention, Karolinska Institutet, Karolinska Hospital, Stockholm, Sweden
- * E-mail: (GZ); (MD)
| | - Guoxi Zheng
- Department of Otorhinolaryngology Head and Neck Surgery, the Second Affiliated Hospital of Xi'an Jiaotong University, Xi’an, Shaanxi, China
- * E-mail: (GZ); (MD)
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Iida E, Anzai Y. Imaging of Paranasal Sinuses and Anterior Skull Base and Relevant Anatomic Variations. Radiol Clin North Am 2016; 55:31-52. [PMID: 27890187 DOI: 10.1016/j.rcl.2016.08.009] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
This article reviews the normal anatomy and variants of the anterior skull base and sinonasal cavities that are relevant to endoscopic sinus and skull base surgery. Radiologists should be aware of sinonasal anatomy that can be impediments to surgical access and increase risk of vascular or cranial nerve injury during surgery. Imaging features of the paranasal sinuses and anterior skull base pathologies are also discussed.
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Affiliation(s)
- Estushi Iida
- Department of Radiology, Yamaguchi University Graduate School of Medicine, 1-1-1 Minami-Kogushi, Ube, Yamaguchi 755-8505, Japan
| | - Yoshimi Anzai
- Department of Radiology, University of Utah Health Sciences Center, 30 North, 1900 East #1A071, Salt Lake City, UT 84132-2140, USA.
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Hwang CS, Seo YW, Park SC, Chung HJ, Cho HJ, Yoon JH, Kim CH. Role of surgical treatment for esthesioneuroblastomas: 31-Year experience at a single institution. J Craniomaxillofac Surg 2016; 45:120-126. [PMID: 27840119 DOI: 10.1016/j.jcms.2016.10.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2016] [Revised: 08/31/2016] [Accepted: 10/10/2016] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE This study aimed to re-assess the outcomes of different surgical methods for esthesioneuroblastoma (ENB) in a single institution, with emphasis on changes in surgical treatment with regard to endoscopic approaches in patients with ENB. SUBJECTS AND METHODS We retrospectively reviewed the data of 35 patients with ENB treated over the last 31 years. RESULTS The 5-year overall and disease-free survival rates were 66.8% and 50.8%, respectively. Disease-free survival in the endoscopic surgery group was significantly higher compared to that of craniofacial surgery group (P = 0.035). In the endoscopic surgery group, nine of 10 patients did not exhibit local failure or regional recurrence over a mean followup period of 64.3 months, which was longer than the mean time to recurrence (22.0 months) observed in this study. CONCLUSION Given its significant survival outcomes and high rate of local control, endoscopic surgery could be preferred as a minimally invasive treatment with potentially low morbidity and possible oncological validity for the treatment of ENB.
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Affiliation(s)
- Chi Sang Hwang
- Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, South Korea
| | - Young Wook Seo
- Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, South Korea
| | - Sang Chul Park
- Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, South Korea
| | - Hyo Jin Chung
- Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, South Korea
| | - Hyung-Ju Cho
- Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, South Korea; The Airway Mucus Institute, Yonsei University College of Medicine, Severance Hospital, Seoul, South Korea
| | - Joo-Heon Yoon
- Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, South Korea; The Airway Mucus Institute, Yonsei University College of Medicine, Severance Hospital, Seoul, South Korea
| | - Chang-Hoon Kim
- Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, South Korea; The Airway Mucus Institute, Yonsei University College of Medicine, Severance Hospital, Seoul, South Korea.
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Abstract
PURPOSE OF REVIEW This article provides a contemporary review of the management of esthesioneuroblastoma (ENB) within the context of recent surgical advancements, while highlighting the ongoing limitations and controversies surrounding this uncommon pathologic entity. RECENT FINDINGS Surgical management of ENB is continuously evolving with contemporary endoscopic approaches complementing or in many cases replacing open approaches. SUMMARY Complete surgical resection remains the mainstay definitive therapy for ENB. Aggressive, combined modality therapy appears to be justified in patients at greatest risk of developing recurrence based on advanced tumor stage and high pathologic grade. ENB requires prolonged surveillance following treatment given its tendency for late recurrence.
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Sabongi JG, Gonçalves MCP, Alves CDC, Alves J, Scapulatempo-Neto C, Moriguchi SM. Lutetium 177-DOTA-TATE therapy for esthesioneuroblastoma: A case report. Exp Ther Med 2016; 12:3078-3082. [PMID: 27882120 DOI: 10.3892/etm.2016.3732] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2014] [Accepted: 01/21/2016] [Indexed: 11/06/2022] Open
Abstract
Esthesioneuroblastoma (ENB), also known as olfactory neuroblastoma, is a rare malignant tumor that accounts for 3% of all tumors of the nasal cavity. The incidence of ENB is 0.4 cases per million in the general population, and the most common symptoms are nasal obstruction and epistaxis. Previous studies have indicated the presence of somatostatin receptors in this tumor type. Common treatment strategies for ENB include resection and adjuvant radiotherapy and/or chemotherapy (combined treatment); however, the rate of recurrence is high. Treatment of neuroendocrine tumors using radionuclides bound to somatostatin analogues is well established in clinical practice. However, a standard and effective therapeutic approach has not been reported for ENB. The current study described the case of a 74-year-old female with numerous recurrences of ENB following multiple treatments and without possibility of resection. The patient was treated with the radiolabeled-somatostatin analogue, 177Lutetium-DOTA-octreotate (177Lu-DOTA-TATE), which successfully controlled the disease. This suggests that 177Lu-DOTA-TATE is a potential treatment for ENB and may represent an effective alternative and novel therapeutic strategy for this disease.
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Affiliation(s)
- Juliano Guerra Sabongi
- Imaging Medical Center, Division of Nuclear Medicine, Medical Centre of Sorocaba, Sorocaba, SP 18031-480, Brazil
| | | | | | - João Alves
- Department of Nuclear Medicine, Dr Ary Pinheiro Base Hospital, Porto Velho, RO 76804-373, Brazil
| | | | - Sonia Marta Moriguchi
- Department of Tropical Diseases and Diagnostic Imaging, Botucatu Medical School, São Paulo State University, Botucatu, SP 18618-970, Brazil
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Abstract
Esthesioneuroblastoma is a rare malignant tumor of sinonasal origin. These tumors typically present with unilateral nasal obstruction and epistaxis, and diagnosis is confirmed on biopsy. Over the past 15 years, significant advances have been made in endoscopic technology and techniques that have made this tumor amenable to expanded endonasal resection. There is growing evidence supporting the feasibility of safe and effective resection of esthesioneuroblastoma via an expanded endonasal approach. This article outlines a technique for endoscopic resection of esthesioneuroblastoma and reviews the current literature on esthesioneuroblastoma with emphasis on outcomes after endoscopic resection of these malignant tumors.
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Affiliation(s)
- Christopher R Roxbury
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, 601 North Caroline Street, 6th Floor, Baltimore, MD 21287, USA
| | - Masaru Ishii
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, 601 North Caroline Street, 6th Floor, Baltimore, MD 21287, USA
| | - Gary L Gallia
- Department of Neurosurgery, Johns Hopkins University School of Medicine, 600 North Wolfe Street, Phipps Building, Room 101, Baltimore, MD 21287, USA
| | - Douglas D Reh
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, 601 North Caroline Street, 6th Floor, Baltimore, MD 21287, USA.
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122
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Shen J, Cui H, Feng S. An isolated orbital mass with proptosis and diplopia: an uncommon metastasis from intracranial olfactory neuroblastoma in a chinese patient. Onco Targets Ther 2016; 9:5281-6. [PMID: 27601919 PMCID: PMC5005001 DOI: 10.2147/ott.si09929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Purpose Olfactory neuroblastoma (ONB) is a rare neuroectodermal malignant neoplasm that originates from the olfactory sensory epithelium. In reported cases involving the orbit, the primary neoplasms could invade the orbits through bone destruction or cranio-orbital communication anatomical structure. The present study reports a rare case of orbital metastatic tumor arising from an intracranial ONB in a Chinese patient, which is the first case demonstrating an uncommon route of ONB involving the orbit. Patient and methods A 62-year-old man with a right orbital tumor was diagnosed as having a secondary tumor arising from intracranial ONB. Clinical examination, including ocular imaging examination, and histopathological and immunohistochemical studies were performed. Results In the ocular examination, a focal, firm, nontender swelling with ill-defined margins in the right orbit was found on palpation. Proptosis, limited eyeball movement, and visual loss were also observed. The unenhanced computed tomography scan showed a homogeneous, isolated, ill-defined soft tissue neoplasm in the right orbit. The histopathological study revealed irregularly shaped nests of tumor cells surrounded by avascularized fibrous stroma. The monomorphic malignant tumor cells are small round blue cells that are slightly larger than mature lymphocytes, with a very high nuclear to cytoplasmic ratio. The immunohistochemical staining for tumor cells was positive for synaptophysin, chromogranin A, cluster of differentiation 56 (CD56), cytokeratin, vimentin, S-100 protein, and negative for epithelial membrane antigen, and cluster of differentiation (CD99). Conclusion This is so far the first Chinese case of orbital metastasis from intracranial ONB that has ever been reported. Metastasis might be another route of ONB invading the orbit besides direct invasion.
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Affiliation(s)
| | | | - Shi Feng
- Department of Pathology, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, People's Republic of China
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123
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Raj GS, Rao GV, Kumar MP, Sudheerkanth K. Maxillofacial esthesioneuroblastoma: A diagnostic complexity. J Oral Maxillofac Pathol 2016; 20:331. [PMID: 27601839 PMCID: PMC4989577 DOI: 10.4103/0973-029x.185922] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Esthesioneuroblastoma is a rare malignant tumor of the sinonasal tract. Oral and maxillofacial pathologists rarely encounter this tumor in their daily practice. Because of their complex anatomic location, non-specific symptoms, varied histomorphology and unfamiliarity, most of the times, the tumor is diagnosed as benign tumor and thereby conservative treatment results in multiple recurrences. A recurrent case of esthesioneuroblastoma in a 24-year-old female patient describing the clinical, histopathological and immunohistochemical features along with differential diagnosis is discussed.
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Affiliation(s)
- G Shyam Raj
- Department of Oral Pathology and Microbiology, Mamata Dental College, Khammam, Telangana, India
| | | | | | - Kondamari Sudheerkanth
- Department of Oral Pathology and Microbiology, Mamata Dental College, Khammam, Telangana, India
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Yunoki M, Suzuki K, Uneda A, Yoshino K. Olfactory neuroblastoma followed by emergency surgery for symptomatic intradural spinal metastasis: A case report. Surg Neurol Int 2016; 7:77. [PMID: 27625887 PMCID: PMC5009576 DOI: 10.4103/2152-7806.188915] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2016] [Accepted: 06/23/2016] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Olfactory neuroblastoma (ONB) is a rare, aggressive tumor of the nasal cavity. It may invade the paranasal cavities and anterior skull base locally but may also metastasize to the cervical lymph nodes, lungs, or distant central nervous system. CASE DESCRIPTION Here, we report a case of ONB in which emergency surgery was performed for intradural spinal metastasis (ISM). The patient was a 52-year-old male who underwent surgery for ONB. The tumor extended from the nasal cavity to the intracranial space and was resected completely. After radiotherapy (60 Gy), the patient was discharged without any neurological deficit except anosmia. Seven months after the surgery, he consulted our department because of progressive tetraparesis. Cervical magnetic resonance imaging demonstrated an intradural spinal mass involving C5-T2 and necessitating emergency surgery. The tumor was resected subtotally followed by 58 Gy whole-spine irradiation. The patient's neurological symptoms improved, however, paralysis of the right upper and both the lower limbs remained. During the 4 months between the spinal surgery and his death, there was no further motor deterioration in any of his four extremities. CONCLUSION This case demonstrates the need to be aware of potential ISM in the follow-up of patients with ONB. The early detection of ISM by spinal MRI is crucial to ensuring good palliative care.
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Affiliation(s)
- Masatoshi Yunoki
- Department of Neurosurgery, Kagawa Rosai Hospital, Kagawa, Japan
| | - Kenta Suzuki
- Department of Neurosurgery, Kagawa Rosai Hospital, Kagawa, Japan
| | - Atsuhito Uneda
- Department of Neurosurgery, Kagawa Rosai Hospital, Kagawa, Japan
| | - Kimihiro Yoshino
- Department of Neurosurgery, Kagawa Rosai Hospital, Kagawa, Japan
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Charles NC, Petris CK, Kim ET. Aggressive esthesioneuroblastoma with divergent differentiation: A taxonomic dilemma. Orbit 2016; 35:357-359. [PMID: 27715372 DOI: 10.1080/01676830.2016.1193537] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
The authors describe an esthesioneuroblastoma (olfactory neuroblastoma) that occurred within the nasal cavity and brain in a 31-year-old man. Following excision, the tumor recurred in the left orbit and in mediastinal lymph nodes. Treatment included orbital excision and systemic chemotherapy. Histopathology showed a high-grade neuroepithelial tumor with positive immunohistochemical markers for neuroendocrine and epithelial components, an unusual combination raising issues concerning taxonomy.
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Affiliation(s)
- Norman C Charles
- a Department of Ophthalmology , New York University Langone Medical Center , New York , New York , USA.,b Department of Pathology , New York University Langone Medical Center , New York , New York , USA
| | - Carisa K Petris
- a Department of Ophthalmology , New York University Langone Medical Center , New York , New York , USA
| | - Eleanore T Kim
- a Department of Ophthalmology , New York University Langone Medical Center , New York , New York , USA
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Akgul MH, Gezen F, Uzunlar AK. Esthesioneuroblastoma located in the thoracic extradural space: Case report. Int J Surg Case Rep 2016; 27:70-73. [PMID: 27552033 PMCID: PMC4995531 DOI: 10.1016/j.ijscr.2016.06.015] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2016] [Revised: 05/26/2016] [Accepted: 06/08/2016] [Indexed: 11/25/2022] Open
Abstract
Objective Esthesioneuroblastoma accounted for only 6% of the malignant nasal cavity neoplasms (ENB) is a rare tumor which originates from the olfactory epithelium. ENB’s are locally agresive and can metastasize by lymphatic and hematogenous routes. A patient with the mass on the nasal dorsum was reported in this article. Case history A 52–year-old-man admitted to the hospital with a 3 months history of progressive nasal obstruction, epistaxis and mass on the nasal dorsum. On rhinoscopy, a polypoid mass was seen in the both nasal cavity and intranasal biopsy with local anesthesia was performed. Histopathologic diagnosis of the tumor was Kadish stage B esthesioneuroblastoma. Tumor was excised by using bilateral endoscopic endonasal resection and lateral rhinotomy approach and paranasal radiotherapy performed postoperatively. Ten months after surgery, neck metastasis was occured and patient was underwent neck dissection. Twenteeth months after initial treatment, distant metastasis was identified on the T 10 vertebra and following the cranial and spinal radiotherapy to the neck he was free of local recurrence at follow up 13 months after surgery. Conclusion It has been known that the metastasis of the ENB to the spinal cord is an uncommon event, and it occurs often years after initial diagnosis. MRI scan is helpful for making the diagnosis, and surgery is the treatment of choice for obtaining diagnostic tissue and debulking the tumor. Radiotherapy is also a mainstay of postoperative treatment.
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Affiliation(s)
- Mehmet Hüseyin Akgul
- Kırıkkale University Medical Faculty, Department of Neurosurgery, Kirikkale, Turkey.
| | - Ferruh Gezen
- Medeniyet University Medical Faculty Department of Neurosurgery, Istanbul, Turkey.
| | - Ali Kemal Uzunlar
- Duzce University Medical Faculty, Department of Pathology, Düzce, Turkey.
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127
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Lapierre A, Selmaji I, Samlali H, Brahmi T, Yossi S. [Esthesioneuroblastoma: A single institution's experience and general literature review]. Cancer Radiother 2016; 20:783-789. [PMID: 27449859 DOI: 10.1016/j.canrad.2016.05.015] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2015] [Revised: 05/24/2016] [Accepted: 05/27/2016] [Indexed: 10/21/2022]
Abstract
PURPOSE Olfactory neuroblastoma or esthesioneuroblastoma is a rare entity among head and neck neoplasms. In this paper, we report the experience of our institution and compare it with a comprehensive review of the literature. PATIENTS AND METHODS We retrospectively analysed clinical and treatment data of patients referred to the Lyon Sud University Hospital (France) for histologically proven olfactive esthesioneuroblastoma. RESULTS Ten patients treated between 1993 and 2015 have been analysed. Disease stage at diagnosis, according to the Kadish staging system, was C in 90% of cases. Median follow-up was 136 months. Ten-year overall survival was 90%. Five- and ten-year progression-free survival were 70% and 50%. Nine patients (90%) underwent surgical resection first. Seven of the nine patients who underwent resection (77%) received adjuvant three-dimensional (3D)-conformal radiotherapy (n=7), intensity-modulated radiotherapy (n=1), or volumetric arctherapy (n=1). The mean dose to the tumour volume was 61Gy. None of the patients received elective nodal irradiation. Two patients received concurrent chemotherapy. Five patients (50%) presented with disease recurrence, which was local (n=1), nodal (n=2) and cerebral (n=2). CONCLUSION Our results are consistent with the literature. Because of the lack of prospective study and the low number of cases in the literature, each institution's experience is of the utmost important to improve standardised management of these tumours.
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Affiliation(s)
- A Lapierre
- Département de radiothérapie, centre hospitalier universitaire Lyon Sud, 165, chemin du Grand-Revoyet, 69495 Pierre-Bénite, France.
| | - I Selmaji
- Département de radiothérapie, centre hospitalier universitaire de Marrakech, Marrakech, Maroc
| | - H Samlali
- Département de radiothérapie, centre hospitalier universitaire de Casablanca, Casablanca, Maroc
| | - T Brahmi
- Département de radiothérapie, centre hospitalier universitaire Lyon Sud, 165, chemin du Grand-Revoyet, 69495 Pierre-Bénite, France
| | - S Yossi
- Département de radiothérapie, centre hospitalier universitaire Lyon Sud, 165, chemin du Grand-Revoyet, 69495 Pierre-Bénite, France
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Söffler C, Hartmann A, Gorgas D, Ludewig E, von Pückler K, Kramer M, Schmidt MJ. Magnetic resonance imaging features of esthesioneuroblastoma in three dogs and one cat. TIERAERZTLICHE PRAXIS AUSGABE KLEINTIERE HEIMTIERE 2016; 44:333-340. [PMID: 27385200 DOI: 10.15654/tpk-150963] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/18/2015] [Accepted: 03/23/2016] [Indexed: 11/13/2022]
Abstract
OBJECTIVE Esthesioneuroblastoma is a rare malignant intranasal tumor that originates from the olfactory neuroepithelium of the upper nasal cavity, and can destroy the cribriform plate and expand into the neurocranium. Descriptions of the magnetic resonance features of esthesioneuroblastomas in animals are scarce. The objectives of this study were to report the magnetic resonance imaging features of esthesioneuroblastomas in order to determine distinct imaging characteristics that may help distinguish it from other intracranial tumor types. MATERIAL AND METHODS Magnetic resonance images of four patients with confirmed esthesioneuroblastomas were reviewed and compared with previously reported cases. RESULTS The esthesioneuroblastomas appeared as oval-shaped, solitary lesions in the caudal nasal cavity that caused osteolysis of the cribriform plate and extended into the brain in all cases. Signal intensity was variable. Contrast enhancement was mild and varied from homogeneous to heterogeneous. A peripheral cystic component was found in two patients and was reported in only one previous case. Mass effect and white matter edema were marked to severe. Osteolysis of facial bones and extension into the facial soft tissues or retrobulbar space were not present in any of the cases, although this has been reported in the literature. CONCLUSION A definitive diagnosis of esthesioneuroblastoma based on signal intensity or contrast behavior was not possible. Nevertheless, the presence of a mass in the caudal nasal cavity with extension into the neurocranium seems to be a feature highly suspicious of esthesioneuroblastoma. In contrast to other extra-cranial lesions, the extra-cranial mass was relatively small and destruction of facial bones seems to be rare.
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Affiliation(s)
- Charlotte Söffler
- Charlotte Söffler, Klinik für Kleintiere der Justus-Liebig-Universität Gießen, Frankfurter Straße 108, 35392 Gießen, Germany,
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129
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Peacock JG, Harmsen WS, Link MJ, Van Gompel JJ, Giannini C, Olsen KD, Garces YI, Neben Wittich MA, Ma DJ, Park SS, Foote RL. Risk of Delayed Lymph Node Metastasis in Clinically N0 Esthesioneuroblastoma. J Neurol Surg B Skull Base 2016; 78:68-74. [PMID: 28180046 DOI: 10.1055/s-0036-1584904] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2016] [Accepted: 05/27/2016] [Indexed: 10/21/2022] Open
Abstract
Objective To determine both the rate of delayed cervical lymph node metastasis in patients with esthesioneuroblastoma (ENB) and a clinically N0 untreated neck and the effectiveness of salvage treatment. Design Retrospective review. Setting Tertiary academic medical center. Participants All patients from January 1, 1965, to December 31, 2010, who received definitive treatment for ENB. Main Outcome Measures The study involved 52 patients: 27 (52%) patients underwent surgery and adjuvant radiotherapy (SART) to the primary site only and 25 (48%) underwent surgery alone (SA) as treatment of the primary site, without elective neck dissection. Results Median follow-up for the SART group was 10 years versus 15.7 years for the SA group. The 10-year delayed cervical lymph node metastasis estimate is 41%. With median follow-up of 47 months after salvage treatment, the 4-year cervical lymph node recurrence-free survival estimate is 70%; the 5-year overall survival estimate is 39%. Conclusions Delayed cervical lymph node metastases are common, indolent, and salvaged effectively in most patients. We propose that patients with ENB and clinically N0 cervical lymph nodes may choose to forego elective neck dissection or elective neck radiotherapy in favor of neck observation within their initial treatment.
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Affiliation(s)
- Justin G Peacock
- Mayo Medical School, Mayo Clinic College of Medicine, Rochester, Minnesota, United States
| | - William S Harmsen
- Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, Minnesota, United States
| | - Michael J Link
- Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota, United States; Department of Otorhinolaryngology - Head and Neck Surgery, Mayo Clinic, Rochester, Minnesota, United States
| | - Jamie J Van Gompel
- Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota, United States; Department of Otorhinolaryngology - Head and Neck Surgery, Mayo Clinic, Rochester, Minnesota, United States
| | - Caterina Giannini
- Division of Anatomic Pathology, Mayo Clinic, Rochester, Minnesota, United States
| | - Kerry D Olsen
- Department of Otorhinolaryngology - Head and Neck Surgery, Mayo Clinic, Rochester, Minnesota, United States
| | - Yolanda I Garces
- Department of Radiation Oncology, Mayo Clinic, Rochester, Minnesota, United States
| | - Michelle A Neben Wittich
- Department of Radiation Oncology, Mayo Clinic, Rochester, Minnesota, United States; Division of General Internal Medicine, Mayo Clinic, Rochester, Minnesota, United States
| | - Daniel J Ma
- Department of Radiation Oncology, Mayo Clinic, Rochester, Minnesota, United States
| | - Sean S Park
- Department of Radiation Oncology, Mayo Clinic, Rochester, Minnesota, United States
| | - Robert L Foote
- Department of Radiation Oncology, Mayo Clinic, Rochester, Minnesota, United States
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130
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Abstract
Esthesioneuroblastoma is a rare malignant tumor of neuroectodermal origin. It usually presents with nonspecific symptoms, such as nasal obstruction, epistaxis, and pain, but has an aggressive course if the treatment is delayed. The authors report a case of esthesioneuroblastoma in a 47-year-old woman, treated with extensive surgical resection, radiotherapy, and chemotherapy. Despite intensive treatment, the patient developed a local recurrence with systemic metastasis and succumbed 4 months later.
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131
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McLean JN, Nunley SR, Klass C, Moore C, Müller S, Johnstone PAS. Combined modality therapy of esthesioneuroblastoma. Otolaryngol Head Neck Surg 2016; 136:998-1002. [PMID: 17547995 DOI: 10.1016/j.otohns.2006.11.051] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2006] [Accepted: 11/30/2006] [Indexed: 10/23/2022]
Abstract
Objective Esthesioneuroblastoma (ENB) is a rare tumor of the olfactory epithelium. The objective of this study was to evaluate treatment modalities including surgery, IMRT, and chemotherapy and patient outcomes. Patients and Methods A retrospective analysis was performed on a total of 21 patients. Therapy included craniofacial resection (CFR), radiotherapy, chemotherapy, or a combination of these methods. Results The median follow-up period was 47 months. Surgery was performed in 90.4% of cases; radiotherapy was performed adjuvantly in 15 (72.7%) patients. Surgery, radiotherapy, and chemotherapy were administered to 7 (33.3%) patients. Eight (38.3%) patients had local recurrence. The 5-year crude overall survival was 71.4% and actuarial 5-year overall survival was 58% with confidence interval (CI, 25 and 81, respectively). The 5-year crude disease-free survival rate was 59% and the 5-year actuarial disease-free survival rate was 62% (CI, 28 and 83, respectively). Conclusion Multidisciplinary therapy of ENB should be considered, especially for Kadish C and high-grade lesions. Craniofacial resection (CFR), Intensity modulated radiation therapy (IMRT), and chemotherapy should be investigated in a multi-institution trial of ENB. © 2007 American Academy of Otolaryngology-Head and Neck Surgery Foundation. All rights reserved.
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Affiliation(s)
- J Nicolas McLean
- Department of Otolaryngology-Head and Neck Surgery, Emory University School of Medicine, Atlanta, GA 30322, USA
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132
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Leon-Soriano E, Alfonso C, Yebenes L, Garcia-Polo J, Lassaletta L, Gavilan J. Bilateral Synchronous Ectopic Ethmoid Sinus Olfactory Neuroblastoma: A Case Report. AMERICAN JOURNAL OF CASE REPORTS 2016; 17:268-73. [PMID: 27097989 PMCID: PMC4841357 DOI: 10.12659/ajcr.897623] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
Patient: Male, 41 Final Diagnosis: Olfactory neuroblastoma Symptoms: Left nasal obstruction • occasional left epistaxis • headache Medication: None Clinical Procedure: Nasal endoscopic examination • neck palpation • CT • bilateral endoscopic resection • MRI • PET-CT • postoperative radiotherapy Specialty: Otolaryngology
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Affiliation(s)
- Elena Leon-Soriano
- Department of Otolaryngology, La Paz University Hospital, La Paz University Hospital Institute for Health Research (IdiPAZ), Madrid, Spain
| | - Carolina Alfonso
- Department of Otolaryngology, La Paz University Hospital, La Paz University Hospital Institute for Health Research (IdiPAZ), Madrid, Spain
| | - Laura Yebenes
- Department of Pathology, La Paz University Hospital, Madrid, Spain
| | - Julio Garcia-Polo
- Department of Otolaryngology, La Paz University Hospital, La Paz University Hospital Institute for Health Research (IdiPAZ), Madrid, Spain
| | - Luis Lassaletta
- Department of Otolaryngology, La Paz University Hospital, La Paz University Hospital Institute for Health Research (IdiPAZ), Madrid, Spain
| | - Javier Gavilan
- Department of Otolaryngology, La Paz University Hospital, La Paz University Hospital Institute for Health Research (IdiPAZ), Madrid, Spain
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133
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Venkatramani R, Pan H, Furman WL, Marron JM, Haduong J, Friedrich-Medina P, Mahajan A, Bavle A, Wu H, Chintagumpala M. Multimodality Treatment of Pediatric Esthesioneuroblastoma. Pediatr Blood Cancer 2016; 63:465-70. [PMID: 26514449 PMCID: PMC5134836 DOI: 10.1002/pbc.25817] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2015] [Revised: 10/05/2015] [Accepted: 10/06/2015] [Indexed: 11/10/2022]
Abstract
BACKGROUND Esthesioneuroblastoma (ENB) is a rare cancer of the nasal cavity in children. Radical surgery followed by postoperative radiation is considered the standard of care in adults. A similar approach in children can lead to significant long-term morbidity. PROCEDURE A retrospective multi-institutional review of patients less than 21 years of age diagnosed with ENB between 1990 and 2014 was performed. Clinical features, treatment, and outcome were obtained from the medical records. RESULTS Twenty-four patients were identified with a median age of 14 years (range 0.6-20 years) at diagnosis. The majority (75%) were females. Headache was the most common presenting symptom, followed by nasal obstruction and epistaxis. Eight patients had Kadish stage B tumors and 16 had Kadish stage C tumors. Nine patients had metastatic disease. Gross total resection was achieved at diagnosis in eight patients and after neoadjuvant chemotherapy in four patients. Twenty-one patients received radiation therapy (45-68.4 Gy). Thirteen patients received neoadjuvant chemotherapy with 84% objective response rate. Seven patients experienced disease progression or relapse-five in central nervous system, one local, and one in cervical lymph node. Fifteen patients were alive at the last follow-up. The 5-year disease-free survival and overall survival were 74% and 73%, respectively. Late effects were observed in 78% of long-term survivors. Four patients developed subsequent malignant neoplasms. CONCLUSIONS Pediatric ENB is a chemosensitive disease. Preoperative chemotherapy-based multimodal approach should be used in patients with advanced stage disease. Radiation therapy is effective for local control, but lower doses should be considered in children.
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Affiliation(s)
- Rajkumar Venkatramani
- Rare Tumors Program, Texas Children’s Cancer Center, Baylor College of Medicine, Houston, Texas
| | - Hubert Pan
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | | | - Jonathan M. Marron
- Dana-Farber/Boston Children’s Cancer and Blood Disorders Center, Boston, Massachusetts
| | | | | | - Anita Mahajan
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Abhishek Bavle
- Rare Tumors Program, Texas Children’s Cancer Center, Baylor College of Medicine, Houston, Texas
| | - Hao Wu
- Department of Pathology, Baylor College of Medicine, Houston, Texas
| | - Murali Chintagumpala
- Rare Tumors Program, Texas Children’s Cancer Center, Baylor College of Medicine, Houston, Texas
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134
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Roxbury CR, Ishii M, Richmon JD, Blitz AM, Reh DD, Gallia GL. Endonasal Endoscopic Surgery in the Management of Sinonasal and Anterior Skull Base Malignancies. Head Neck Pathol 2016; 10:13-22. [PMID: 26830407 PMCID: PMC4746133 DOI: 10.1007/s12105-016-0687-8] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2015] [Accepted: 11/05/2015] [Indexed: 11/24/2022]
Abstract
Sinonasal malignancies represent a rare subset of tumors with a wide variety of histopathologic diagnoses and overall poor prognosis. These tumors tend to have an insidious onset with non-specific symptoms which often leads to delayed diagnosis and advanced local disease at presentation. The principal goal of surgery is to obtain a negative margin resection. Open craniofacial techniques are well established in the management of sinonasal malignancies and remain the treatment of choice for many advanced tumors. Over the past couple of decades, there has been tremendous application of endoscopic techniques to skull base pathologies including sinonasal malignancies. For selected cases, endonasal endoscopic techniques can be performed with curative intent and reduced surgical morbidity and mortality. Here we discuss principles of surgical management of sinonasal malignancies, review the techniques of endonasal endoscopic resection of sinonasal malignancies, and highlight the importance of pathology in the multi-disciplinary management of patients with these complex lesions.
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Affiliation(s)
- Christopher R Roxbury
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA
| | - Masaru Ishii
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA
- Department of Neurosurgery, Johns Hopkins University School of Medicine, 600 North Wolfe Street, Phipps Building, Room 101, Baltimore, MD, 21287, USA
| | - Jeremy D Richmon
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA
| | - Ari M Blitz
- Division of Neuroradiology, Department of Radiology, Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA
| | - Douglas D Reh
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA
- Department of Neurosurgery, Johns Hopkins University School of Medicine, 600 North Wolfe Street, Phipps Building, Room 101, Baltimore, MD, 21287, USA
| | - Gary L Gallia
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA.
- Department of Neurosurgery, Johns Hopkins University School of Medicine, 600 North Wolfe Street, Phipps Building, Room 101, Baltimore, MD, 21287, USA.
- Department of Oncology, Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA.
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135
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Shah K, Perez-Ordóñez B. Neuroendocrine Neoplasms of the Sinonasal Tract: Neuroendocrine Carcinomas and Olfactory Neuroblastoma. Head Neck Pathol 2016; 10:85-94. [PMID: 26830400 PMCID: PMC4746139 DOI: 10.1007/s12105-016-0696-7] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2015] [Accepted: 10/05/2015] [Indexed: 01/27/2023]
Abstract
Neuroendocrine neoplasms (NENs) can occur in organs or tissues that do not contain neuroendocrine cells normally and do not necessarily imply embryologic derivation from the neuroectoderm; but rather reflect a shared phenotype characterized by the expression of multiple genes encoding both endocrine and neuronal features. NENs are rare in the sinonasal tract and are subdivided into epithelial and neural subtypes based on the presence of keratins or neurofilaments, respectively. Although relatively rare, neuroendocrine carcinomas (NECs) and olfactory neuroblastoma (ONB) are the most common neuroendocrine neoplasms of the sinonasal tract. The focus of this review is to highlight recent developments in the pathology of sinonasal NECs and ONB in light of the upcoming update of the World Health Organization (WHO) 2005 classification of tumors of the head and neck.
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Affiliation(s)
- Ketan Shah
- Department of Pathology, John Radcliffe Hospital, Oxford, UK
| | - Bayardo Perez-Ordóñez
- Department of Pathology, John Radcliffe Hospital, Oxford, UK ,Laboratory Medicine Program, Department of Pathology, Toronto General Hospital, University Health Network, 200 Elizabeth Street, Toronto, ON M5G 2C4 Canada
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136
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Uslu GH, Canyilmaz E, Zengin AY, Mungan S, Yoney A, Bahadir O, Gocmez H. Olfactory neuroblastoma: A case report. Oncol Lett 2016; 10:3651-3654. [PMID: 26788185 DOI: 10.3892/ol.2015.3821] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2014] [Accepted: 10/05/2015] [Indexed: 11/05/2022] Open
Abstract
Olfactory neuroblastoma (ON) is a rare type of malignant neoplasm originating from the olfactory neuroepithelial cells of the nasal cavity. ON is also known as esthesioneuroblastoma or neuroendocrine carcinoma. The malignancy accounts for <3% of tumors originating in the nasal cavity. Through the nasal cavity, ON may infiltrate the sinuses, the orbit and the cranium. The tumor is characterized by a pattern of slow growth and local recurrences. Treatment options are surgical excision or surgery combined with a radiotherapy (RT) and/or chemotherapy combination treatment. The present study reports the case of a 69-year-old patient with a mass in the nasal cavity who was treated by combined surgical excision and RT. The literature for ON and the treatment of the tumor are also discussed.
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Affiliation(s)
- Gonca Hanedan Uslu
- Department of Radiation Oncology, Faculty of Medicine, Kanuni Research and Education Hospital, Trabzon 61040, Turkey
| | - Emine Canyilmaz
- Department of Radiation Oncology, Faculty of Medicine, Karadeniz Technical University, Trabzon 61080, Turkey
| | - Ahmet Yasar Zengin
- Department of Radiation Oncology, Faculty of Medicine, Kanuni Research and Education Hospital, Trabzon 61040, Turkey
| | - Sevdegul Mungan
- Department of Pathology, Faculty of Medicine, Karadeniz Technical University, Trabzon 61080, Turkey
| | - Adnan Yoney
- Department of Radiation Oncology, Faculty of Medicine, Karadeniz Technical University, Trabzon 61080, Turkey
| | - Osman Bahadir
- Department of Otorhinolaryngology, Faculty of Medicine, Karadeniz Technical University, Trabzon 61080, Turkey
| | - Huseyin Gocmez
- Department of Radiation Oncology, Faculty of Medicine, Kanuni Research and Education Hospital, Trabzon 61040, Turkey
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137
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Abstract
The nasal cavity and paranasal sinuses occupy the top of the upper respiratory tract and form pneumatic spaces connected with the atmosphere. They are located immediately beneath the base of the cranium, where crucial vital structures are harbored. From this region, very much exposed to airborne agents, arise some of the more complex and rare benign and malignant lesions seen in humans, whose difficulties in interpretation make this remarkable territory one of the most challenging in the practice of surgical pathology. Contents of this chapter cover inflammations and infections, polyps and pseudotumors, fungal and midfacial destructive granulomatous lesions, as well as benign, borderline, and malignant neoplasms. Among the neoplasms, emphasis is made on those entities characteristic or even unique for the sinonasal region, such as Schneiderian papillomas, glomangiopericytoma, intestinal- and non-intestinal-type adenocarcinomas, olfactory neuroblastoma, nasal-type NK-/T-cell lymphoma, and teratocarcinosarcoma. Moreover, recently recognized entities involving this territory, i.e., HPV-related non-keratinizing carcinoma, NUT carcinoma, and SMARCB1-deficient basaloid carcinoma, are also discussed in the light of their specific molecular findings. Furthermore, the text is accompanied by numerous classical and recent references, several tables, and 100 illustrations.
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Affiliation(s)
- Antonio Cardesa
- University of Barcelona, Anatomic Pathology Hospital Clínic University of Barcelona, Barcelona, Spain
| | - Pieter J. Slootweg
- Radboud Univ Nijmegen Medical Center, Pathology Radboud Univ Nijmegen Medical Center, Nijmegen, The Netherlands
| | - Nina Gale
- University of Ljubljana,, Institute of Pathology, Faculty of Medic University of Ljubljana,, Ljublijana, Slovenia
| | - Alessandro Franchi
- University of Florence, Dept of Surg & Translational Medicine University of Florence, Florence, Italy
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138
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Nalavenkata SB, Sacks R, Adappa ND, Palmer JN, Purkey MT, Feldman MD, Schlosser RJ, Snyderman CH, Wang EW, Woodworth BA, Smee R, Havas TE, Gallagher R, Harvey RJ. Olfactory Neuroblastoma: Fate of the Neck--A Long-term Multicenter Retrospective Study. Otolaryngol Head Neck Surg 2015; 154:383-9. [PMID: 26671900 DOI: 10.1177/0194599815620173] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2015] [Accepted: 11/10/2015] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Olfactory neuroblastoma and the management of neck disease has posed considerable challenges to the treating physician. The aims of the study were to determine the incidence and factors influencing neck disease and to identify at-risk patients with cervical node-negative disease at presentation. STUDY DESIGN Multicenter case series with retrospective chart review. SETTING AND SUBJECTS In sum, 113 patients with a histopathologic diagnosis of olfactory neuroblastoma across 6 tertiary hospitals in Australia and the United States. METHODS Treatment modalities for the primary site and neck included surgery, radiotherapy, and combined therapy. Treatment outcomes were measured in relation to date of primary treatment, and long-term follow-up was recorded. Disease-free survival was calculated as time for patients to develop delayed neck disease following primary treatment. RESULTS A total of 113 patients (46 females, 49.7 ± 13.2 years) were identified with a median follow-up of 41.5 months (interquartile range, 58.2); 7.1% of patients presented with primary neck disease, while 8.8% of patients presented with delayed neck disease. Neck disease was present in patients with Hyams grade II (22.2%), III (55.6%), and IV (22.2%) lesions (χ(2) = 5.66, P = .13). Histologic grade was higher in patients with primary neck disease (χ(2) = 16.22, P = .001). Positive surgical margins were associated with a higher risk of delayed neck disease as compared with clear surgical margin (17.9% vs 5%, P = .034). CONCLUSION Neck metastasis is an important clinical consideration for olfactory neuroblastoma at presentation and in surveillance. Primary treatment of the neck could be considered in select patients. Long-term surveillance of the neck and primary site is essential.
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Affiliation(s)
- Sunny B Nalavenkata
- Sydney Medical School, University of Sydney, Sydney, Australia Rhinology and Skull Base Research Group, Applied Medical Research Centre, St Vincent's Hospital, University of New South Wales, Sydney, Australia
| | - Raymond Sacks
- Sydney Medical School, University of Sydney, Sydney, Australia Faculty of Medicine and Health Sciences, Macquarie University, Sydney, Australia Department of Otolaryngology, Concord General Hospital, Sydney, Australia
| | - Nithin D Adappa
- Department of Otolaryngology, University of Pennsylvania, Philadelphia, Pennsylvania, United States
| | - James N Palmer
- Department of Otolaryngology, University of Pennsylvania, Philadelphia, Pennsylvania, United States
| | | | - Michael D Feldman
- Department of Otolaryngology, University of Pennsylvania, Philadelphia, Pennsylvania, United States
| | - Rodney J Schlosser
- Department of Otolaryngology, Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina, United States
| | - Carl H Snyderman
- Department of Otolaryngology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, United States
| | - Eric W Wang
- Department of Otolaryngology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, United States
| | - Bradford A Woodworth
- Department of Otolaryngology, University of Alabama at Birmingham, Birmingham, Alabama, United States
| | - Robert Smee
- Department of Radiation Oncology, The Prince of Wales Cancer Centre, Sydney, Australia
| | - Thomas E Havas
- Department of Otolaryngology, Head and Neck Surgery, Prince of Wales and Sydney Hospitals, Sydney, Australia
| | - Richard Gallagher
- Rhinology and Skull Base Research Group, Applied Medical Research Centre, St Vincent's Hospital, University of New South Wales, Sydney, Australia
| | - Richard J Harvey
- Rhinology and Skull Base Research Group, Applied Medical Research Centre, St Vincent's Hospital, University of New South Wales, Sydney, Australia Faculty of Medicine and Health Sciences, Macquarie University, Sydney, Australia
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139
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Jiang W, Mohamed ASR, Fuller CD, Kim BYS, Tang C, Gunn GB, Hanna EY, Frank SJ, Su SY, Diaz E, Kupferman ME, Beadle BM, Morrison WH, Skinner H, Lai SY, El-Naggar AK, DeMonte F, Rosenthal DI, Garden AS, Phan J. The role of elective nodal irradiation for esthesioneuroblastoma patients with clinically negative neck. Pract Radiat Oncol 2015; 6:241-247. [PMID: 26979544 DOI: 10.1016/j.prro.2015.10.023] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2015] [Revised: 10/27/2015] [Accepted: 10/31/2015] [Indexed: 11/17/2022]
Abstract
PURPOSE Although adjuvant radiation to the tumor bed has been reported to improve the clinic outcomes of esthesioneuroblastoma (ENB) patients, the role of elective neck irradiation (ENI) in clinically node-negative (N0) patients remains controversial. Here, we evaluated the effects of ENI on neck nodal relapse risk in ENB patients treated with radiation therapy as a component of multimodality treatment. METHODS AND MATERIALS Seventy-one N0 ENB patients irradiated at the University of Texas MD Anderson Cancer Center between 1970 and 2013 were identified. ENI was performed on 22 of these patients (31%). Survival analysis was performed with focus on comparative outcomes of those patients who did and did not receive ENI. RESULTS The median follow-up time for our cohort is 80.8 months (range, 6-350 months). Among N0 patients, 13 (18.3%) developed neck nodal relapses, with a median time to progression of 62.5 months. None of these 13 patients received prophylactic neck irradiation. ENI was associated with significantly improved regional nodal control at 5 years (regional control rate of 100% for ENI vs 82%, P < .001), but not overall survival or disease-free survival. Eleven patients without ENI developed isolated neck recurrences. All had further treatment for their neck disease, including neck dissection (n = 10), radiation (n = 10), or chemotherapy (n = 5). Six of these 11 patients (54.5%) demonstrated no evidence of further recurrence with a median follow-up of 55.5 months. CONCLUSION ENI significantly reduces the risk of cervical nodal recurrence in ENB patients with clinically N0 neck, but this did not translate to a survival benefit. Multimodality treatment for isolated neck recurrence provides a reasonable salvage rate. The greatest benefit for ENI appeared to be among younger patients who presented with Kadish C disease. Further studies are needed to confirm these findings.
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Affiliation(s)
- Wen Jiang
- Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Abdallah S R Mohamed
- Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas; Department of Clinical Oncology and Nuclear Medicine, Faculty of Medicine, University of Alexandria, Egypt
| | - Clifton David Fuller
- Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Betty Y S Kim
- Department of Neurosurgery, MD Anderson Cancer Center, Houston, Texas; Department of Neurosurgery, Mayo Clinic, Jacksonville, Florida
| | - Chad Tang
- Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas
| | - G Brandon Gunn
- Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Ehab Y Hanna
- Department of Head and Neck Surgery, MD Anderson Cancer Center, Houston, Texas
| | - Steven J Frank
- Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Shirley Y Su
- Department of Head and Neck Surgery, MD Anderson Cancer Center, Houston, Texas
| | - Eduardo Diaz
- Department of Head and Neck Surgery, MD Anderson Cancer Center, Houston, Texas
| | - Michael E Kupferman
- Department of Head and Neck Surgery, MD Anderson Cancer Center, Houston, Texas
| | - Beth M Beadle
- Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas
| | - William H Morrison
- Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Heath Skinner
- Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Stephen Y Lai
- Department of Head and Neck Surgery, MD Anderson Cancer Center, Houston, Texas
| | - Adel K El-Naggar
- Department of Pathology, MD Anderson Cancer Center, Houston, Texas
| | - Franco DeMonte
- Department of Neurosurgery, MD Anderson Cancer Center, Houston, Texas
| | - David I Rosenthal
- Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Adam S Garden
- Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas.
| | - Jack Phan
- Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas.
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140
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Jiang W, Liu J, Gullane PJ, Gentili F, Wharen RE, Kim BYS, DeMonte F. Non-contiguous meningeal metastases of olfactory neuroblastoma. J Neurooncol 2015; 126:201-203. [PMID: 26376653 DOI: 10.1007/s11060-015-1935-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2015] [Accepted: 09/07/2015] [Indexed: 10/23/2022]
Abstract
Olfactory neuroblastoma (ONB) is a malignant neoplasm centered along the roof of the nasal cavity near the cribriform plate. Although metastasis of this tumor has been reported, non-contiguous spread to the dura is rare. Here, we report the largest series of intracranial meningeal metastases of ONBs from M.D. Anderson Cancer Center and the University of Toronto. The unique natural history and geographical distribution of these metastatic lesions suggest a common mechanism of tumor spread along the dural vascular arborization.
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Affiliation(s)
- Wen Jiang
- Department of Radiation Oncology, The University of Texas M. D. Anderson Cancer Center, 1515 Holcombe Blvd., Houston, TX, 77030, USA
| | - Jieqiong Liu
- Department of Breast Surgery, Sun Yat-sen Memorial Hospital, Breast Tumor Center, Sun Yat-sen University, Guangzhou, China
| | - Patrick J Gullane
- Department of Head and Neck Surgery, University of Toronto, 399 Bathurst Street, Toronto, ON, M5T 2S8, USA
| | - Fred Gentili
- Department of Neurosurgery, University of Toronto, 399 Bathurst Street, Toronto, ON, M5T 2S8, USA
| | - Robert E Wharen
- Department of Neurosurgery, Mayo Clinic College of Medicine, 4500 San Pablo Road, Jacksonville, FL, 32224, USA
| | - Betty Y S Kim
- Department of Neurosurgery, Mayo Clinic College of Medicine, 4500 San Pablo Road, Jacksonville, FL, 32224, USA.
| | - Franco DeMonte
- Department of Neurosurgery, The University of Texas M. D. Anderson Cancer Center, 1515 Holcombe Blvd., Houston, TX, 77030, USA.
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141
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Syndrome of inappropriate antidiuretic hormone secretion associated with olfactory neuroblastoma. J Craniofac Surg 2015; 24:2189-93. [PMID: 24220439 DOI: 10.1097/scs.0b013e3182a41c52] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
This study reports a patient having olfactory neuroblastoma complicated by syndrome of inappropriate antidiuretic hormone secretion. Olfactory neuroblastoma is a rare tumor that begins in the olfactory membrane. Only 10 cases have been reported previously. Because of having nonspecific symptoms, most patients manifest at an advanced stage at the time of diagnosis. Olfactory neuroblastoma may show local invasion and/or distant metastasis. We demonstrated preoperatively clinical and biochemical parameters consistent with antidiuretic hormone syndrome turned to normal ranges after the treatment. Surgery, chemotherapy, and radiotherapy are the choices of treatment; among these, surgery is an indispensible treatment.
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142
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Dublin AB, Bobinski M. Imaging Characteristics of Olfactory Neuroblastoma (Esthesioneuroblastoma). J Neurol Surg B Skull Base 2015; 77:1-5. [PMID: 26949582 DOI: 10.1055/s-0035-1564053] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Abstract
This presentation outlines the clinical and imaging characteristics of esthesioneuroblastoma.
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Affiliation(s)
- Arthur B Dublin
- Department of Radiology, Section of Neuroradiology, University of California-Davis Medical Center, Sacramento, California, United States
| | - Matthew Bobinski
- Department of Radiology, Section of Neuroradiology, University of California-Davis Medical Center, Sacramento, California, United States
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143
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MacIntosh PW, Jakobiec FA, Stagner AM, Gilani S, Fay A. High grade neuroendocrine neoplasm of the antrum and orbit. Surv Ophthalmol 2015; 60:486-94. [DOI: 10.1016/j.survophthal.2015.03.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2014] [Revised: 03/19/2015] [Accepted: 03/25/2015] [Indexed: 11/15/2022]
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144
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Abstract
OBJECTIVES Esthesioneuroblastoma is an uncommon cancer of the nasal cavity. We describe the outcomes for 26 patients treated with curative intent with photon radiotherapy (RT) at the University of Florida. METHODS Between May 1972 and June 2007, 26 patients received RT for previously untreated esthesioneuroblastoma of the nasal cavity. Sixteen patients were males and 10 were females with a median age of 55 years (range, 3 to 82 y). The modified Kadish stage distribution was: B, 7 patients; C, 17 patients; and D, 2 patients. Treatment modalities included the following: definitive RT, 5 patients; preoperative RT, 2 patients; and postoperative RT after resection, 19 patients. Elective neck irradiation (ENI) was performed in 17 (71%) of 24 N0 patients. RESULTS Rates of local control, cause-specific survival, and absolute overall survival at 5 years were 79%, 72%, and 69%, respectively. Overall survival among patients treated with definitive RT was 20% at 5 years, compared with 81% among those who underwent surgery and adjuvant RT (P=0.01). One (6%) of 17 patients who received ENI developed a recurrence in the neck and was successfully salvaged. Ultimate neck control was 100% at 5 years for patients who received ENI versus 69% among those not receiving ENI (P=0.0173). CONCLUSIONS Resection combined with adjuvant RT is more effective than surgery or RT alone in the treatment of esthesioneuroblastoma. ENI reduces the risk of regional relapse in patients with Kadish stage B and C cancers.
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145
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Microvessel density and Ki-67 labeling index in esthesioneuroblastoma: is there a prognostic role? Ann Diagn Pathol 2015; 19:391-6. [PMID: 26343569 DOI: 10.1016/j.anndiagpath.2015.06.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2014] [Revised: 06/03/2015] [Accepted: 06/24/2015] [Indexed: 11/23/2022]
Abstract
Esthesioneuroblastoma (ENB) is a malignant neuroectodermal tumor. Hyams grading has an established role in its prognostication. The importance of microvessel density (MVD) and Ki-67 labeling index (Ki-67 LI) is well studied in various tumors, but the same remains understated in ENB. The aims of the study were to estimate proliferation index and MVD in ENB and to correlate them with Hyams grade. Twenty-six ENB cases diagnosed over a period of 5 years were included. Hyams grade, MVD, and Ki-67 LI were evaluated for each of them. The cases were categorized as low (Hyams grades 1 and 2) and high (Hyams grades 3 and 4) grades. Microvessel density and Ki-67 LI were correlated with grade. The treatment response was analyzed in different grades. The commonest histologic grade was 4 (42%). The mean Ki-67 LI was 2%, 8.2%, 30.8%, and 40.5% and mean MVD was 81.67/mm(2), 37/mm(2), 24/mm(2), and 25.2/mm(2) in grades 1, 2, 3, and 4, respectively. A statistically significant correlation of grade with Ki-67 LI (P < .001) and MVD (P < .007) was noted. Hyams grade in ENB correlates well with treatment response. Ki-67 LI is an important prognostic factor in ENB. We propose a cutoff of 25% for Ki-67 LI to differentiate low- vs high-grade ENB, but larger studies are needed for validation. Contrary to epithelial tumors, there is a decrease in MVD with increasing grade in ENB.
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146
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Bell D, Hanna EY, Weber RS, DeMonte F, Triantafyllou A, Lewis JS, Cardesa A, Slootweg PJ, Stenman G, Gnepp DR, Devaney KO, Rodrigo JP, Rinaldo A, Wenig BM, Westra WH, Bishop JA, Hellquist H, Hunt JL, Kusafuka K, Perez-Ordoñez B, Williams MD, Takes RP, Ferlito A. Neuroendocrine neoplasms of the sinonasal region. Head Neck 2015; 38 Suppl 1:E2259-66. [PMID: 26041714 DOI: 10.1002/hed.24152] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2015] [Revised: 05/18/2015] [Accepted: 05/31/2015] [Indexed: 11/06/2022] Open
Abstract
Neuroendocrine neoplasms of the sinonasal region, which are relatively uncommon but clinically very important, are reviewed here in the light of current knowledge. Using a definition for neuroendocrine based on phenotypic, histologic, immunohistochemical, and electron microscopic features rather than histogenetic criteria, sinonasal neuroendocrine carcinomas are examined with a particular emphasis on the small-cell and large-cell subtypes. This is followed by revisiting olfactory neuroblastoma because it is also a tumor that shows a neuroendocrine phenotype. Kadish clinical and Hyams histologic grading systems as prognosticators of olfactory neuroblastoma are also considered in detail. Finally, controversies regarding sinonasal undifferentiated carcinoma as a neuroendocrine tumor are discussed and a possible relationship with high-grade olfactory neuroblastoma is explored. Genetic events and current management of these tumors are also outlined. © 2015 Wiley Periodicals, Inc. Head Neck 38: E2259-E2266, 2016.
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Affiliation(s)
- Diana Bell
- Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, Texas.,Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Ehab Y Hanna
- Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Randal S Weber
- Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Franco DeMonte
- Department of Neurosurgery, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Asterios Triantafyllou
- Oral and Maxillofacial Pathology, School of Dentistry, University of Liverpool and Cellular Pathology, University Hospital Aintree, Liverpool, United Kingdom
| | - James S Lewis
- Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, Missouri
| | - Antonio Cardesa
- Department of Anatomic Pathology, Hospital Clinic, University of Barcelona, Barcelona, Spain
| | - Pieter J Slootweg
- Department of Pathology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Göran Stenman
- Sahlgrenska Cancer Center, Department of Pathology, University of Gothenburg, Gothenburg, Sweden
| | - Douglas R Gnepp
- Head and Neck Pathology, University Pathologists, Warwick, Rhode Island and Fall River, Massachusetts
| | | | - Juan P Rodrigo
- Department of Otolaryngology, Hospital Universitario Central de Asturias, Oviedo, Spain.,Instituto Universitario de Oncología del Principado de Asturias, University of Oviedo, Oviedo, Spain
| | | | - Bruce M Wenig
- Department of Pathology, Beth Israel Medical Center, New York, New York
| | - William H Westra
- Departments of Pathology and Otolaryngology-Head and Neck Surgery, The Johns Hopkins Medical Institutions, Baltimore, Maryland
| | - Justin A Bishop
- Departments of Pathology and Otolaryngology-Head and Neck Surgery, The Johns Hopkins Medical Institutions, Baltimore, Maryland
| | - Henrik Hellquist
- Departamento de Ciências, Biomédicas e Medicina, Universidade do Algavre, Faro, Portugal
| | - Jennifer L Hunt
- Department of Pathology, University of Arkansas for Medical Sciences, Little Rock, Arkansas
| | - Kimihide Kusafuka
- Pathology Division, Shizuoka Cancer Center Hospital and Research Institute, Shizuoka, Japan
| | - Bayardo Perez-Ordoñez
- Department of Pathology, Toronto General Hospital, University Health Network, Toronto, Ontario, Canada.,Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada
| | - Michelle D Williams
- Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Robert P Takes
- Department of Otolaryngology-Head and Neck Surgery, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Alfio Ferlito
- Coordinator of the International Head and Neck Scientific Group
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147
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Buohliqa L, Upadhyay S, Nicolai P, Cavalieri R, Dolci RLL, Prevedello D, Carrau RL. Possible esthesioneuroblastoma metastasis to paranasal sinuses: Clinical report and literature review. Head Neck 2015; 38:E32-6. [PMID: 25946111 DOI: 10.1002/hed.24095] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/17/2015] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Local recurrence, and regional and distant metastases, respectively, develop in 30% and 15% of patients with esthesioneuroblastoma (ENB). METHODS This case report includes 3 patients with unusual recurrences of ENB in the sinonasal tract. RESULTS Patient 1 developed ENB in the bilateral maxillary sinuses after unilateral endoscopic resection of a left ENB followed by postoperative proton radiotherapy. Patient 2 developed ENB at the left optic-carotid recess 7 years after a craniofacial resection and postoperative radiotherapy. Patient 3 developed ENB over the left zygomatic process of the maxilla 4 years after a cranioendoscopic resection and postoperative radiation therapy for ENB of the ethmoid sinuses with intracranial extension. The possibility of venous tumor emboli must be considered as a likely etiology. However, alternative explanations include the development of a second primary or potential transformation because of tumor signaling. CONCLUSION We present 3 cases that may represent metastasis of ENB within the sinonasal tract.
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Affiliation(s)
- Lamia Buohliqa
- Department of Otolaryngology-Head and Neck Surgery, Wexner Medical Center at The Ohio State University, Columbus, Ohio
| | - Smita Upadhyay
- Department of Otolaryngology-Head and Neck Surgery, Wexner Medical Center at The Ohio State University, Columbus, Ohio
| | - Piero Nicolai
- Department of Otolaryngology-Head and Neck Surgery, University of Brescia, Brescia, Italy
| | - Robert Cavalieri
- Department of Medical Oncology, Neuro-Oncology Division, Wexner Medical Center at The Ohio State University, Columbus, Ohio
| | - Ricardo L L Dolci
- Department of Otolaryngology-Head and Neck Surgery, Wexner Medical Center at The Ohio State University, Columbus, Ohio
| | - Daniel Prevedello
- Department of Otolaryngology-Head and Neck Surgery, Wexner Medical Center at The Ohio State University, Columbus, Ohio.,Department of Neurosurgical Surgery, Wexner Medical Center at The Ohio State University, Columbus, Ohio
| | - Ricardo L Carrau
- Department of Otolaryngology-Head and Neck Surgery, Wexner Medical Center at The Ohio State University, Columbus, Ohio.,Department of Neurosurgical Surgery, Wexner Medical Center at The Ohio State University, Columbus, Ohio
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148
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Petruzzelli G, Howell J, Pederson A, Origitano T, Byrne R, Munoz L, Emami B, Clark J. Multidisciplinary treatment of olfactory neuroblastoma: Patterns of failure and management of recurrence. Am J Otolaryngol 2015; 36:547-53. [PMID: 25749259 DOI: 10.1016/j.amjoto.2015.02.008] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2015] [Accepted: 02/14/2015] [Indexed: 01/20/2023]
Abstract
PURPOSE Esthesioneuroblastoma is an uncommon malignancy of the head and neck for which there is no defined treatment protocol. The purpose of this study is to report our experience with the treatment and patterns of failure of this disease. METHODS AND MATERIALS From 1994 to 2012, 37 previously unreported patients with esthesioneuroblastoma were evaluated, and 32 eventually treated for cure at 2 academic medical centers. All patients were staged with Kadish criteria. The mean and median follow-ups were 96.1 and 76.5 months respectively (range 6-240 months). RESULTS The Kadish stage was A in 6 patients, B in 13 patients, and C in 13 patients. Four patients were initially treated with concurrent chemo-radiation therapy. Twenty-eight patients were treated with primary surgery. Two (2) underwent open medial maxillectomy and 26 underwent craniofacial resection (open - 17, endoscopic - 9). Three patients received curative surgical resection only. Seven patients failed either within the cranial axis or distantly, 6 of the 7 are dead of disease, 10-194 months following initial treatment. Six patients had isolated neck recurrences, 4/6 were salvaged with neck dissection and additional chemo-radiation and remain alive 30-194 months following initial treatment. Estimated overall survival rate at 10 years was 78% based on Kadish and T stages. CONCLUSION In this retrospective analysis of 32 patients, Kadish stage C and stage T3/T4 tumors were associated with worse outcome. Total radiation dose of 60 Gy, margin status, patient age, were not found to have significant prognostic value.
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149
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Saade RE, Hanna EY, Bell D. Prognosis and biology in esthesioneuroblastoma: the emerging role of Hyams grading system. Curr Oncol Rep 2015; 17:423. [PMID: 25416317 DOI: 10.1007/s11912-014-0423-z] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Esthesioneuroblastoma is a sinonasal tumor with distinct clinicopathologic features, multiple facets, and a spectrum of behavior. Characterization of this disease is challenging, and clinically, several staging systems have been used with no consensus on a single scheme. Recently, the Hyams histological grading system has emerged as a promising prognostication tool that offers an added value to stage. This review addresses prognosis and biology in esthesioneuroblastoma. More specifically, we sought to present a critical appraisal on the value of each of these stratification systems, stage vs. grade, in identifying risk groups and guiding management.
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Affiliation(s)
- Rami E Saade
- Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard (Unit 123), Houston, TX, 77030, USA,
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150
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Vučinić N, Erić M, Ergin T, Özyar E, Vučković N. Treatment of olfactory neuroblastoma: a new approach. Acta Neurol Belg 2015; 115:195-8. [PMID: 24934414 DOI: 10.1007/s13760-014-0319-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2014] [Accepted: 05/31/2014] [Indexed: 11/29/2022]
Affiliation(s)
- Nikola Vučinić
- Department of Anatomy, Faculty of Medicine, University of Novi Sad, Hajduk Veljkova 3, 21000, Novi Sad, Serbia,
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