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Akay S, Pollard JH, Saad Eddin A, Alatoum A, Kandemirli S, Gholamrezanezhad A, Menda Y, Graham MM, Shariftabrizi A. PET/CT Imaging in Treatment Planning and Surveillance of Sinonasal Neoplasms. Cancers (Basel) 2023; 15:3759. [PMID: 37568575 PMCID: PMC10417627 DOI: 10.3390/cancers15153759] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 07/20/2023] [Accepted: 07/21/2023] [Indexed: 08/13/2023] Open
Abstract
Sinonasal cancers are uncommon malignancies with a generally unfavorable prognosis, often presenting at an advanced stage. Their high rate of recurrence supports close imaging surveillance and the utilization of functional imaging techniques. Whole-body 18F-FDG PET/CT has very high sensitivity for the diagnosis of sinonasal malignancies and can also be used as a "metabolic biopsy" in the characterization of some of the more common subgroups of these tumors, though due to overlap in uptake, histological confirmation is still needed. For certain tumor types, radiotracers, such as 11C-choline, and radiolabeled somatostatin analogs, including 68Ga-DOTATATE/DOTATOC, have proven useful in treatment planning and surveillance. Although serial scans for posttreatment surveillance allow the detection of subclinical lesions, the optimal schedule and efficacy in terms of survival are yet to be determined. Pitfalls of 18F-FDG, such as post-surgical and post-radiotherapy crusting and inflammation, may cause false-positive hypermetabolism in the absence of relapse.
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Affiliation(s)
- Sinan Akay
- Division of Nuclear Medicine, Department of Radiology, Carver College of Medicine, University of Iowa, Iowa City, IA 52242, USA
| | - Janet H. Pollard
- Division of Nuclear Medicine, Department of Radiology, Carver College of Medicine, University of Iowa, Iowa City, IA 52242, USA
| | - Assim Saad Eddin
- Division of Nuclear Medicine, Department of Radiology, Carver College of Medicine, University of Iowa, Iowa City, IA 52242, USA
| | - Aiah Alatoum
- Division of Nuclear Medicine, Department of Radiology, Carver College of Medicine, University of Iowa, Iowa City, IA 52242, USA
| | - Sedat Kandemirli
- Division of Nuclear Medicine, Department of Radiology, Carver College of Medicine, University of Iowa, Iowa City, IA 52242, USA
| | - Ali Gholamrezanezhad
- Department of Radiology, Keck School of Medicine, University of Southern California (USC), Los Angeles, CA 90030, USA
| | - Yusuf Menda
- Division of Nuclear Medicine, Department of Radiology, Carver College of Medicine, University of Iowa, Iowa City, IA 52242, USA
| | - Michael M. Graham
- Division of Nuclear Medicine, Department of Radiology, Carver College of Medicine, University of Iowa, Iowa City, IA 52242, USA
| | - Ahmad Shariftabrizi
- Division of Nuclear Medicine, Department of Radiology, Carver College of Medicine, University of Iowa, Iowa City, IA 52242, USA
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Dondi F, Albano D, Bertoli M, Bertagna F, Giubbini R. 68Ga-DOTATOC PET/CT and MR in the Evaluation of Meningeal Metastasis From Esthesioneuroblastoma: A Case Report. Clin Nucl Med 2021; 46:e378-e380. [PMID: 33782294 DOI: 10.1097/rlu.0000000000003593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
ABSTRACT Esthesioneuroblastoma is a rare malignant tumor arising from olfactory neuroepithelium. PET/CT with different tracers such as 18F-FDG and 68Ga-somatostatin-receptor tracers has demonstrated its utility for the evaluation of disease. We present the case of a woman previously treated for esthesioneuroblastoma performing MR and 18Ga-DOTATOC PET/CT demonstrating dural metastasis of disease with a strong correspondence between conventional and functional imaging.
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Affiliation(s)
- Francesco Dondi
- From the Nuclear Medicine, University of Brescia and ASST Spedali Civili Brescia
| | - Domenico Albano
- From the Nuclear Medicine, University of Brescia and ASST Spedali Civili Brescia
| | - Mattia Bertoli
- Nuclear Medicine, ASST Spedali Civili Brescia, Brescia, Italy
| | - Francesco Bertagna
- From the Nuclear Medicine, University of Brescia and ASST Spedali Civili Brescia
| | - Raffaele Giubbini
- From the Nuclear Medicine, University of Brescia and ASST Spedali Civili Brescia
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Caldwell NJ, Sato TS. Ectopic primary olfactory neuroblastoma of the nasopharynx: A case report and review of the literature. Radiol Case Rep 2019; 14:997-1002. [PMID: 31198483 PMCID: PMC6556859 DOI: 10.1016/j.radcr.2019.05.031] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Revised: 05/27/2019] [Accepted: 05/27/2019] [Indexed: 11/04/2022] Open
Abstract
Olfactory neuroblastoma (ONB, also called esthesioneuroblastoma) is a rare malignant tumor of neuroectodermal olfactory cells. We report a case of an undifferentiated ONB with unfavorable histology arising ectopically in the nasopharynx. The patient was a 15-year-old male who presented with a right-sided painful neck mass, nasal obstruction, and weight loss. Awareness of the ectopic ONBs, although exceedingly rare, is important when considering differential diagnoses of sinonasal tumors as treatment and prognosis may differ from other lesions.
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Affiliation(s)
- Nicholas J Caldwell
- Carver College of Medicine, University of Iowa, 375 Newton Rd, Iowa City, IA 52242, USA
| | - T Shawn Sato
- Carver College of Medicine, University of Iowa, 375 Newton Rd, Iowa City, IA 52242, USA.,Department of Radiology, University of Iowa Hospitals and Clinics, 200 Hawkins Dr. Iowa City, IA 52242, USA
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Imaging features of sinonasal tumors on positron emission tomography and magnetic resonance imaging including diffusion weighted imaging: A pictorial review. Clin Imaging 2018; 51:217-228. [DOI: 10.1016/j.clinimag.2018.05.018] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2018] [Revised: 05/17/2018] [Accepted: 05/24/2018] [Indexed: 11/19/2022]
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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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Elkhatib AH, Soldatova L, Carrau RL, Hachem RA, Ditzel L, Campbell R, Prevedello DM, Prevedello L, Filho LFSD, Campbell RG. Role of 18 F-FDG PET/CT differentiating olfactory neuroblastoma from sinonasal undifferentiated carcinoma. Laryngoscope 2016; 127:321-324. [PMID: 27481043 DOI: 10.1002/lary.26194] [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: 04/10/2016] [Revised: 06/10/2016] [Accepted: 06/22/2016] [Indexed: 11/07/2022]
Abstract
OBJECTIVES The purpose of this study is to demonstrate the potential contribution of positron emission tomography (PET)/computed tomography (CT) to help differentiate olfactory neuroblastoma (ONB) from sinonasal undifferentiated carcinoma (SNUC). METHODS Following approval by the institutional review board at the Wexner Medical Center at the Ohio State University, Columbus, Ohio, a pilot study with retrospective review of patients with biopsy-proven diagnosis of ONB s and SNUC s was conducted. Staging PET/CT scans were reviewed to document the maximum standardized uptake value (SUVmax). A statistical comparison of SUVmax was performed. RESULTS We identified 13 patients (7 with ONBs and 6 with SNUCs) with mean age 60.2 years who had undergone staging F-18 fluorodeoxyglucose (18 F-FDG) PET/CT of the primary tumor at the time of their diagnosis. Mean SUVmax was found to be five-fold higher in SNUC patients (35.63, range 10.8-77.9) than in ONB patients (7.24, range 4.6-10.7) (P ≤ 0.00169). CONCLUSION Maximum standardized uptake value of 18 F-FDG PET/CT can be used to initially discriminate between ONB and SNUC. This finding may prove helpful to guide diagnostic and treatment planning when the histopathologic diagnosis is inconclusive. LEVEL OF EVIDENCE 4. Laryngoscope, 2016 127:321-324, 2017.
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Affiliation(s)
- Ahmad H Elkhatib
- Department of Otolaryngology-Head and Neck Surgery, The Ohio State University Wexner Medical Center, Ohio, U.S.A
| | - Liuba Soldatova
- College of Medicine, The Ohio State University, Columbus, Ohio, U.S.A
| | - Ricardo L Carrau
- Department of Otolaryngology-Head and Neck Surgery, The Ohio State University Wexner Medical Center, Ohio, U.S.A.,Department of Neurological Surgery, The Ohio State University Wexner Medical Center, Ohio, U.S.A
| | - Ralph Abi Hachem
- Department of Otolaryngology-Head and Neck Surgery, The Ohio State University Wexner Medical Center, Ohio, U.S.A
| | - Leo Ditzel
- Department of Neurosurgery, Hospital Santa Cruz, Curitiba, Brazil
| | - Raewyn Campbell
- Department of Otolaryngology-Head & Neck Surgery, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia
| | - Daniel M Prevedello
- Department of Otolaryngology-Head and Neck Surgery, The Ohio State University Wexner Medical Center, Ohio, U.S.A.,Department of Neurological Surgery, The Ohio State University Wexner Medical Center, Ohio, U.S.A
| | - Luciano Prevedello
- Department of Radiology, The Ohio State University Wexner Medical Center, Ohio, U.S.A
| | | | - Raewyn G Campbell
- Department of Otolaryngology-Head & Neck Surgery, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia
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Abstract
PURPOSE The present study evaluated the usefulness of postoperative fluorine-18 fluorodeoxyglucose (F-FDG) PET/computed tomography (CT) in the management of olfactory neuroblastoma (ONB). MATERIALS AND METHODS Ten patients (eight men and two women; mean age, 48.5 years) with histologically confirmed ONB who underwent craniofacial resection were retrospectively included in this study. A total of 42 whole-body F-FDG PET/CT scans for postoperative surveillance or restaging were reviewed. The mean time from operation until the PET/CT scan was 42.1 months. We evaluated the F-FDG uptake and the presence of recurrent lesions during the follow-up period and compared the PET/CT results with the results of MRI and clinical examination (endoscopy). RESULTS Seven of the 10 patients had 24 recurrent lesions, and 18 of these recurrent lesions (seven local recurrences, eight cervical lymph node metastases, one intracranial metastasis, and two distant metastases) were F-FDG positive (75.0%). Three local recurrences and three intracranial metastases were false negative and were detected by endoscopy and MRI, respectively. The mean time from operation until recurrence was 51.4 months, and 17 lesions (70.8%) occurred more than 2 years after the initial operation. CONCLUSION Although F-FDG PET/CT is useful for the detection of postoperative recurrences of ONB, long-term follow-up combined with endoscopy and MRI is mandatory.
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König MS, Osnes T, Meling TR. Treatment of esthesioneuroblastomas. Neurochirurgie 2014; 60:151-7. [PMID: 24975203 DOI: 10.1016/j.neuchi.2014.03.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2013] [Revised: 03/04/2014] [Accepted: 03/05/2014] [Indexed: 10/25/2022]
Abstract
OBJECTIVE To analyze the clinical features, treatment outcomes, pattern of failures, and course of the disease of a cohort of patients treated for esthesioneuroblastoma (ENB) with craniofacial resection (CFR) at a single institution during a 12-year period. MATERIAL AND METHODS Retrospective analysis of 11 patients with ENB treated with CFR in a tertiary care academic medical center from 1998 to 2009. RESULTS Median age at diagnosis was 51 years (range 41-67 years). The most common presenting symptom was nasal obstruction (91%). Four patients (36%) presented with Kadish stage B, six patients (55%) with Kadish stage C, and one patient (9%) with Kadish stage D. The initial treatment was craniofacial resection (CFR) alone for three patients (23%), CFR followed by postoperative radiation therapy (RT) in seven patients (64%), while one patient (9%) received both neoadjuvant and adjuvant RT in addition to surgery. The mean and median follow-up times were 66 and 58 months, respectively (range 23-158 months). Seven patients are currently alive with no evidence of disease (64%), while two patients are alive with disease (18%). Overall survival was 100% at one year postoperatively and 80% five years after the primary treatment. The progression free survival was calculated to 73% at one year and 64% at five years. CONCLUSIONS ENB is an uncommon diagnosis with an incidence of 0.037/100,000 persons/year in the catchment area of our institution. Treatment can be challenging, especially with advanced disease. CFR with RT offers good oncologic disease control with minimal morbidity.
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Affiliation(s)
- M S König
- Department of neurology, Ostfold hospital trust, 1603 Fredrikstad, Norway.
| | - T Osnes
- Department of otorhinolaryngology, Oslo university hospital, Rikshospitalet, 0027 Oslo, Norway.
| | - T R Meling
- Department of neurosurgery, Oslo university hospital, Rikshospitalet, 0027 Oslo, Norway.
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Karam SD, Jay AK, Anyanwu C, Steehler MK, Davidson B, Debrito P, Harter KW. Pathologic collision of inverted papilloma with esthesioneuroblastoma. Front Oncol 2014; 4:44. [PMID: 24672769 PMCID: PMC3953676 DOI: 10.3389/fonc.2014.00044] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2014] [Accepted: 02/24/2014] [Indexed: 11/17/2022] Open
Abstract
Background: Inverted papilloma (IP) of the nasal cavity is a benign tumor that represents 0.5–4% of all nasal tumors and have been known to rarely undergo malignant transformation to squamous carcinoma and even more rarely adenocarcinoma. Synchronous association with low-grade esthesioneuroblastoma (ENB) has been reported in only one case report where a small-sized lesion was treated with surgery alone. Here we report the first case of invasion of IP by high-grade ENB with nodal metastasis that was treated with combined modality therapy. Case Presentation: A case of a 64-year-old African American gentleman presented to the otolaryngology with a 3-month history of recurrent epistaxis. Imaging revealed a large right nasal cavity mass extending into the right sphenoid sinus but without intracranial extension. Surgical pathology revealed high-grade ENB invading IP. An orbitofrontal craniotomy approach was used to achieve complete resection of the mass but with positive margins. Post-operative positron emission tomography/computed tomography showed nodal metastasis. The patient was then treated with adjuvant chemoradiation and remains without evidence of disease at 42 months post-treatment. We discuss the disease presentation, histopathologic features, and disease management with literature support. Conclusion: In this very rare disease presentation where two extremely rare malignancies collide, we show that aggressive management with trimodality therapy of surgery, adjuvant radiation with stereotactic radiosurgical boost, and adjuvant chemotherapy gives excellent results. Given the natural history of the disease, however, long follow-up is needed to declare complete freedom from the disease.
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Affiliation(s)
- Sana D Karam
- Department of Radiation Oncology, Georgetown University Hospital , Washington, DC , USA
| | - Ann K Jay
- Department of Radiology, Georgetown University Hospital , Washington, DC , USA
| | - Cynthia Anyanwu
- Department of Otolaryngology, Georgetown University Hospital , Washington, DC , USA
| | - Matthew K Steehler
- Department of Otolaryngology, Georgetown University Hospital , Washington, DC , USA
| | - Bruce Davidson
- Department of Otolaryngology, Georgetown University Hospital , Washington, DC , USA
| | - Pedro Debrito
- Department of Pathology, Georgetown University Hospital , Washington, DC , USA
| | - K William Harter
- Department of Radiation Oncology, Georgetown University Hospital , Washington, DC , USA
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Bak M, Wein RO. Esthesioneuroblastoma: a contemporary review of diagnosis and management. Hematol Oncol Clin North Am 2012; 26:1185-207. [PMID: 23116576 DOI: 10.1016/j.hoc.2012.08.005] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Esthesioneuroblastoma (ENB) is a rare malignancy, representing only 3% to 6% of all sinonasal malignancies. A wide array of treatment options for ENB have been described in the literature, but prospective clinical trials are absent given the tumor's rarity and natural history. Delay in diagnosis leading to an initial advanced stage of presentation is common secondary to the clinically hidden primary site at the anterior skull base. This article presents data from the current body of literature and reviews the advocated roles for surgery, radiation therapy and chemotherapy.
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Affiliation(s)
- Matthew Bak
- Eastern Virginia Medical School, Norfolk, VA 23507, USA
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