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El Omri M, Njima MB, Mesbah L, Kermani W, Bellakhdher M, Andelkefi M. Exophthalmos revealing an olfactory esthesioneuroblastoma: A case report. Int J Surg Case Rep 2024; 119:109757. [PMID: 38754157 PMCID: PMC11109320 DOI: 10.1016/j.ijscr.2024.109757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2024] [Revised: 05/08/2024] [Accepted: 05/11/2024] [Indexed: 05/18/2024] Open
Abstract
INTRODUCTION AND IMPORTANCE Olfactory neuroblastoma or esthesioneuroblastoma is a rare malignant tumour, that develops in the olfactory neuroepithelium and is one of the rarest tumours of the nasal cavity. Ocular manifestations are uncommon. The diagnosis is based on histology: biopsy, immunohistochemistry and ultrastructural findings. CASE PRESENTATION We report a case of olfactory neuroblastoma of the olfactory placode in a 36-year-old woman with orbital involvement. Computed tomography and magnetic resonance imaging of the skull, showed a suspicious lesion with significant orbital and cranial extension. After anatomopathological study of the biopsy, a protocol palliative radiotherapy was established. CLINICAL DISCUSSION We discuss the clinical, radiological, anatomopathological and therapeutic aspects of this condition, emphasising the importance of evoking this diagnosis in the presence of unilateral tumour-like exophthalmos associated with suggestive rhinological signs. CONCLUSION Ophthalmological involvement usually occurs at an advanced stage of esthesioneuroblastoma. This case highlights the fatal course of olfactory neuroblastoma. As it can present with the comlex symptoms related to ocular and nasal sites. Early diagnosis is the key to better therapeutic choices according to its level of extension, purposing at the best possible prognosis for the patient.
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Affiliation(s)
- Malika El Omri
- Department of Ear, Nose, Throat and Head and Neck Surgery, Farhat Hached University Hospital, Sousse, Tunisia.
| | - Maroua Ben Njima
- Department of Ear, Nose, Throat and Head and Neck Surgery, Farhat Hached University Hospital, Sousse, Tunisia
| | - Linda Mesbah
- Department of Ear, Nose, Throat and Head and Neck Surgery, Farhat Hached University Hospital, Sousse, Tunisia
| | - Wassim Kermani
- Department of Ear, Nose, Throat and Head and Neck Surgery, Farhat Hached University Hospital, Sousse, Tunisia
| | - Mouna Bellakhdher
- Department of Ear, Nose, Throat and Head and Neck Surgery, Farhat Hached University Hospital, Sousse, Tunisia
| | - Mohamed Andelkefi
- Department of Ear, Nose, Throat and Head and Neck Surgery, Farhat Hached University Hospital, Sousse, Tunisia
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A review of nasal, paranasal, and skull base tumors invading the orbit. Surv Ophthalmol 2017; 63:389-405. [PMID: 28739401 DOI: 10.1016/j.survophthal.2017.07.001] [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: 04/20/2017] [Revised: 07/16/2017] [Accepted: 07/17/2017] [Indexed: 11/20/2022]
Abstract
Tumors that invade the orbit are uncommon. The majority are meningiomas arising from the sphenoid ridge (66%). Others are bone and cartilage tumors arising from the surrounding bones of the orbit, pituitary adenomas, and epithelial tumors arising from the paranasal sinuses and nasal cavity. Meningiomas occur more often in women, whereas epithelial tumors have a predilection for men. Meningiomas and epithelial tumors typically present in the sixth decade of life, whereas bone tumors tend to affect individuals in their third decade of life. Patients often present with a combination of ophthalmological and otorhinolaryngological symptoms, including proptosis, pain, decreased visual acuity, restrictions in motility of the eye, epistaxis, and nasal obstruction. Sarcomas and benign bone and cartilage tumors arise from surrounding structures, whereas carcinomas usually arise from the paranasal sinuses. Surgery is the mainstay of treatment. Depending on the aggressiveness and histology of the tumor, surgery may be combined with radiation and chemotherapy. The prognosis is generally poor, but varies depending on histology and cell origin, size of the tumor, and degree of invasion. Meningiomas and benign bone tumors have the best prognoses. Sinonasal undifferentiated carcinomas, small-cell neuroendocrine carcinomas, osteosarcomas, and rhabdomyosarcomas have poorer prognoses.
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Breazzano MP, Lewis JS, Chambless LB, Rohde SL, Sobel RK. Remote orbital recurrence of olfactory neuroblastoma (esthesioneuroblastoma). Orbit 2017; 36:247-250. [PMID: 28362545 DOI: 10.1080/01676830.2017.1287742] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Olfactory neuroblastoma is a rare and often locally aggressive malignancy that invades the orbit via local destruction. It is known to recur in a delayed fashion, particularly to the neck lymph nodes. This is a case of a 65-year-old gentleman who presents with recurrence in the orbit and a neck lymph node 19 years after treatment for his initial disease. This report describes the longest known interval in orbital recurrence and should alert the monitoring physician that extreme delays in recurrence can occur.
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Affiliation(s)
- Mark P Breazzano
- a Department of Ophthalmology & Visual Sciences, Vanderbilt University School of Medicine, Vanderbilt Eye Institute , Vanderbilt University Medical Center , Nashville , TN , USA
| | - James S Lewis
- b Department of Pathology, Microbiology, and Immunology, Vanderbilt University School of Medicine , Vanderbilt University Medical Center , Nashville , TN , USA.,c Department of Otolaryngology, Vanderbilt University School of Medicine , Vanderbilt University Medical Center , Nashville , TN , USA
| | - Lola B Chambless
- d Department of Neurological Surgery, Vanderbilt University School of Medicine , Vanderbilt University Medical Center , Nashville , TN , USA
| | - Sarah L Rohde
- c Department of Otolaryngology, Vanderbilt University School of Medicine , Vanderbilt University Medical Center , Nashville , TN , USA
| | - Rachel K Sobel
- a Department of Ophthalmology & Visual Sciences, Vanderbilt University School of Medicine, Vanderbilt Eye Institute , Vanderbilt University Medical Center , Nashville , TN , USA
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Capelle L, Krawitz H. Esthesioneuroblastoma: a case report of diffuse subdural recurrence and review of recently published studies. J Med Imaging Radiat Oncol 2008; 52:85-90. [PMID: 18373833 DOI: 10.1111/j.1440-1673.2007.01919.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Esthesioneuroblastoma is a rare malignancy arising from the olfactory epithelium. We present a case history of a 75-year-old man who presented with a Kadish stage C esthesioneuroblastoma and underwent craniofacial surgery and adjuvant radiotherapy. Two years later he was found to have diffuse subdural deposits with distant bone and nodal metastases, treated with further radiotherapy. The patient's condition subsequently deteriorated and he died. Given this unusual pattern of failure, we review the recent published studies regarding the natural history, treatment and outcome for this tumour.
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Affiliation(s)
- L Capelle
- Department of Radiation Oncology, Auckland City Hospital, Auckland, New Zealand.
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Gil-Carcedo E, Gil-Carcedo LM, Vallejo LA, de Campos JM. [Esthesioneuroblastoma treatment]. ACTA OTORRINOLARINGOLOGICA ESPANOLA 2006; 56:389-95. [PMID: 16353783 DOI: 10.1016/s0001-6519(05)78635-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
INTRODUCTION Esthesioneuroblastoma is an uncommon malignancy of the olfactory neuroepithelium. The best treatment has yet to be defined. The purpose of this study is to analyze the tumors's behaviour to choose the ideal treatment, the therapeutic strategy and the patterns of failure. MATERIALS AND METHODS We carry out a revision of the series published between 1994 to 2004. In these series, we found 39 papers with 713 patients. DISCUSSION CONCLUSIONS In this review the 5-years survival rate is 51.2%. Through the analysis of 583 partients found in 34 publications, surgery (alone or combined) is the treatment most used (78%). The commonly management is surgical in combination with radiotherapy (47%).
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Affiliation(s)
- E Gil-Carcedo
- Cátedra de Otorrinolaringología, Departamento de Cirugía, Servicio de ORL y PCF, Hospital Universitario Rio Hortega, Universidad de Valladolid, SACYL.
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Laforest C, Selva D, Crompton J, Leibovitch I. Orbital invasion by esthesioneuroblastoma. Ophthalmic Plast Reconstr Surg 2006; 21:435-40. [PMID: 16304521 DOI: 10.1097/01.iop.0000184322.79438.2b] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE Esthesioneuroblastoma is a rare malignancy arising from the olfactory mucosa in the nasal fossa, which can invade the orbit producing ophthalmic symptoms and signs. The purpose of this study was to present a case series and review the literature to assess the characteristics of orbital involvement by esthesioneuroblastoma. METHODS Retrospective case series of all patients treated for biopsy-proven esthesioneuroblastoma at the Royal Adelaide Hospital between 1992 and 2004. RESULTS Nine patients (5 male, 4 female) with a mean age of 50 years (range, 20 to 66 years) were reviewed. One case was classified as Kadish stage A, 1 as Kadish stage B, and 7 as Kadish stage C. Mean time from onset of symptoms to diagnosis was 17 months (range, 2 to 24 months). Radiologic orbital invasion was present in 4 cases and was associated with ophthalmic symptoms or signs in 3 of these cases. These included proptosis (2 cases), periorbital pain (1 case), decreased visual acuity (1 case), extraocular muscle restriction (1 case), and chemosis (1 case). One patient with symptoms secondary to orbital invasion was initially referred to and assessed by an ophthalmologist. All patients who had or went on to have development of orbital invasion had advanced disease at diagnosis. Treatment was surgical (9/9), with the addition of radiotherapy (6/9) and chemotherapy (2/9). Mean follow-up was 3.6 years (range, 0.5 to 8.5 years). Six of 9 patients had tumor recurrence. Two had metastasis. Five of 9 patients remained alive. CONCLUSIONS Orbital invasion by esthesioneuroblastoma is not uncommon. It is important to be aware of this malignancy because a significant proportion of patients will present with ophthalmic signs and symptoms.
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Affiliation(s)
- Caroline Laforest
- Oculoplastic and Orbital Unit, Department of Ophthalmology and Visual Sciences, Royal Adelaide Hospital, University of Adelaide, Adelaide, South Australia
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Abstract
Sinonasal disease is one of the most common clinical head and neck pathologies. The majority of sinonasal pathology is inflammatory with neoplasms comprising approximately 3% of all head and neck tumours. Although sinus tumours are rare, they portend a poor prognosis, often due to advanced disease at diagnosis. Like most neoplasms, early detection improves prognosis, therefore clinicians and radiologists should be aware of features separating tumours from inflammatory sinus disease. This article reviews the anatomy, clinical features, imaging findings, treatment and histopathology of selected sinonasal tumours. Benign neoplasms reviewed include osteoma, inverting papilloma, and juvenile nasal angiofibroma. Malignant neoplasms reviewed include squamous cell carcinoma, the minor salivary gland tumour, adenoid cystic carcinoma, adenocarcinoma, melanoma, lymphoma, and olfactory neuroblastoma (esthesioneuroblastoma).
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Affiliation(s)
- Sudip Das
- LAS Otolaryngology, Leicester Royal Infirmary, Leicester, UK
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Kapur R, Mafee MF, Lamba R, Edward DP. Orbital Schwannoma and Neurofibroma: Role of Imaging. Neuroimaging Clin N Am 2005; 15:159-74. [PMID: 15927866 DOI: 10.1016/j.nic.2005.02.004] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Schwannomas are well-circumscribed ovoid masses that most commonly present in the superior orbit. Although it may be difficult to differentiate these benign masses from other orbital tumors on radiologic imaging, the CT and, in particular, the MR imaging characteristics can sometimes point to the diagnosis of a nerve sheath tumor. A definitive diagnosis can be made through correlation with histopathologic findings, however. In most cases, schwannomas have low malignant potential, and with total excision, recurrence is rare.
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Affiliation(s)
- Rashmi Kapur
- Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago, MC 648, 1855 West Taylor Street, Chicago, IL 60612, USA
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