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Hirunpat P, Panyaping T, Hirunpat S. Olfactory Neuroblastoma Is Not Always Located at the Roof of the Nasal Cavity. J Belg Soc Radiol 2024; 108:39. [PMID: 38826683 PMCID: PMC11141505 DOI: 10.5334/jbsr.3562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2024] [Accepted: 03/22/2024] [Indexed: 06/04/2024] Open
Abstract
Objectives To evaluate the imaging characteristics of the tumor, emphasizing its location, and to determine the frequency of typical and atypical locations of olfactory neuroblastoma (ONB). Materials and Methods We retrospectively reviewed the computed tomography and magnetic resonance imaging findings of patients with pathologically proven ONB between April 2000 and April 2023. Demographic information, chief complaints, tumor location, and tumor extension were extracted. Results Of the 58 patients, 50 (86.2%) had the epicenter of the mass at the superior part of the nasal cavity, while eight patients (13.8%) had the epicenter at other atypical locations: seven patients (12.1%) at the middle part of the nasal cavity and one patient (1.7%) within both sphenoid sinuses. Conclusion ONB is not always present in the upper part or the roof of the nasal cavity, and a significant number of ONBs are occasionally found in the rest of the nasal cavity and other atypical locations.
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Affiliation(s)
- Pornrujee Hirunpat
- Chakri Naruebodindra Medical Institute, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Samut Prakan, Thailand
| | - Theeraphol Panyaping
- Division of Neurological Radiology, Department of Diagnostic and Therapeutic Radiology, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Siriporn Hirunpat
- Department of Radiology, Faculty of Medicine, Prince of Songkla University, Hat-Yai, Songkhla, Thailand
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2
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Lui CG, Badash I, Tang L, Mark ME, Batra PS, Wrobel BB. Ectopic Olfactory Neuroblastoma: Systematic Review of a Rare Clinical Entity among Sinonasal Tumors. J Neurol Surg B Skull Base 2024; 85:109-118. [PMID: 38463937 PMCID: PMC10923629 DOI: 10.1055/a-1993-7790] [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: 07/29/2022] [Accepted: 12/01/2022] [Indexed: 12/12/2022] Open
Abstract
Objectives Ectopic olfactory neuroblastoma is an uncommon manifestation of an already rare neoplasm. We aimed to systematically review the literature for cases of ectopic olfactory neuroblastoma to better characterize this rare disease entity and to present two new case reports. Methods A search of the PubMed and Embase databases was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines to identify English-language articles reporting cases of ectopic olfactory neuroblastoma, published from 1955 through November 2021. Results Sixty-six cases of ectopic olfactory neuroblastoma were identified in 62 articles including the current review. Ectopic olfactory neuroblastoma arose in a wide age range (2-89 years) without significant sex predilection. It occurred most commonly in the ethmoid (25%), maxillary (25%), and sphenoid (16%) sinuses. Seventy-three percent of cases presented with low Hyams grade (I and II). The most common symptoms were nasal obstruction (32%) and epistaxis (32%). Paraneoplastic syndromes were observed in 27% of patients. The most common treatment was surgical resection followed by adjuvant radiotherapy. Overall, 76% of all patients were disease-free at the time of last follow-up. Locoregional recurrences and distant metastases were found in 19 and 5% of cases, respectively. Conclusion This systematic review describes previously reported cases of ectopic olfactory neuroblastoma, a disease entity with poorly understood characteristics. Physicians should consider olfactory neuroblastoma in the differential diagnosis for sinonasal masses, as their ectopic presentation may present considerable diagnostic and therapeutic difficulties. Patients with olfactory neuroblastoma may benefit from long-term follow-up and routine endoscopic examinations for surveillance of ectopic recurrences.
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Affiliation(s)
- Christopher G. Lui
- Department of Otolaryngology - Head & Neck Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois, United States
| | - Ido Badash
- Caruso Department of Otolaryngology - Head and Neck Surgery, Keck School of Medicine, University of Southern California, Los Angeles, California, United States
| | - Liyang Tang
- Caruso Department of Otolaryngology - Head and Neck Surgery, Keck School of Medicine, University of Southern California, Los Angeles, California, United States
| | - Michelle E. Mark
- Department of Otorhinolaryngology - Head and Neck Surgery, Rush University Medical Center, Chicago, Illinois, United States
| | - Pete S. Batra
- Department of Otorhinolaryngology - Head and Neck Surgery, Rush University Medical Center, Chicago, Illinois, United States
| | - Bozena B. Wrobel
- Caruso Department of Otolaryngology - Head and Neck Surgery, Keck School of Medicine, University of Southern California, Los Angeles, California, United States
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Wong E, Choroomi S, Palme CE, Singh NP. Isolated primary maxillary sinus esthesioneuroblastoma presenting as idiopathic syndrome of inappropriate antidiuretic hormone. BMJ Case Rep 2019; 12:e228666. [PMID: 31142486 PMCID: PMC6557341 DOI: 10.1136/bcr-2018-228666] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/15/2019] [Indexed: 11/03/2022] Open
Abstract
Esthesioneuroblastoma is an uncommon tumour, and isolated primary involvement of the maxillary sinus is exceedingly rare. Esthesioneuroblastoma has infrequently been reported as a source of paraneoplastic ectopic hormone production. We report a case of isolated primary maxillary esthesioneuroblastoma, presenting as idiopathic syndrome of inappropriate antidiuretic hormone (SIADH). A 17-year-old girl presented with symptoms consistent with SIADH and no sino-nasal symptoms. MRI to exclude pituitary tumour revealed an isolated lesion of the right maxillary sinus. Biopsy demonstrated esthesioneuroblastoma. The lesion was removed endoscopically as a single en bloc specimen. Following resection, the sodium level returned to normal. This is only the third report in the literature of a primary maxillary esthesioneuroblastoma presenting as SIADH.
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Affiliation(s)
- Eugene Wong
- Department of Otolaryngology, University of Sydney Westmead Clinical School, Sydney, New South Wales, Australia
| | - Siamak Choroomi
- Department of Otolaryngology, University of Sydney Westmead Clinical School, Sydney, New South Wales, Australia
| | - Carsten E Palme
- Department of Otolaryngology, University of Sydney Westmead Clinical School, Sydney, New South Wales, Australia
| | - Narinder Pal Singh
- Department of Otolaryngology, Head and Neck Surgery, Westmead Hospital, Sydney, New South Wales, Australia
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Peckham ME, Wiggins RH, Orlandi RR, Anzai Y, Finke W, Harnsberger HR. Intranasal Esthesioneuroblastoma: CT Patterns Aid in Preventing Routine Nasal Polypectomy. AJNR Am J Neuroradiol 2018; 39:344-349. [PMID: 29217745 DOI: 10.3174/ajnr.a5464] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2017] [Accepted: 09/18/2017] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Esthesioneuroblastoma is a neuroectodermal tumor that commonly arises in the nasal cavity olfactory recess and, when isolated to the intranasal cavity, can be indistinguishable from benign processes. Because lesional aggressiveness requires a more invasive operation for resection than polypectomy, patients with isolated intranasal lesions were studied to define distinguishing CT characteristics. MATERIALS AND METHODS Patients with intranasal esthesioneuroblastoma and controls without esthesioneuroblastoma with olfactory recess involvement were identified by using a report search tool. Studies demonstrating skull base invasion and/or intracranial extension were excluded. The imaging spectrum of these lesions was reviewed on both CT and MR imaging, and CT findings were compared with those of controls without esthesioneuroblastoma. Two blinded readers assessed subjects with esthesioneuroblastomas and controls without esthesioneuroblastoma and, using only CT criteria, rated their level of suspicion for esthesioneuroblastoma in each case. RESULTS Eight histologically proved cases of intranasal esthesioneuroblastoma were reviewed. All cases had CT demonstrating 3 main findings: 1) an intranasal polypoid lesion with its epicenter in a unilateral olfactory recess, 2) causing asymmetric olfactory recess widening, and 3) extending to the cribriform plate. Twelve patients with non-esthesioneuroblastoma diseases involving the olfactory recess were used as controls. Using these 3 esthesioneuroblastoma CT criteria, 2 blinded readers evaluating patients with esthesioneuroblastoma and controls had good diagnostic accuracy (area under the curve = 0.85 for reader one, 0.81 for reader 2) for predicting esthesioneuroblastoma. CONCLUSIONS Esthesioneuroblastoma can present as a well-marginated intranasal lesion that unilaterally widens the olfactory recess. CT patterns can help predict esthesioneuroblastoma, potentially preventing multiple operations by instigating the correct initial operative management.
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Affiliation(s)
- M E Peckham
- From the Departments of Radiology and Imaging Sciences (M.E.P., R.H.W., Y.A., W.F., H.R.H.)
| | - R H Wiggins
- From the Departments of Radiology and Imaging Sciences (M.E.P., R.H.W., Y.A., W.F., H.R.H.)
- Division of Otolaryngology-Head and Neck Surgery (R.H.W., R.R.O.)
- BioMedical Informatics (R.H.W.), University of Utah Health Sciences Center, Salt Lake City, Utah
| | - R R Orlandi
- Division of Otolaryngology-Head and Neck Surgery (R.H.W., R.R.O.)
| | - Y Anzai
- From the Departments of Radiology and Imaging Sciences (M.E.P., R.H.W., Y.A., W.F., H.R.H.)
| | - W Finke
- From the Departments of Radiology and Imaging Sciences (M.E.P., R.H.W., Y.A., W.F., H.R.H.)
| | - H R Harnsberger
- From the Departments of Radiology and Imaging Sciences (M.E.P., R.H.W., Y.A., W.F., H.R.H.)
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von Zeidler SV, Guidi R, Alencar RDCG, Aguiar R, Mendonça EF, Batista AC, Ribeiro-Rotta RF. Atypical esthesioneuroblastoma invading oral cavity: a case report and review of the literature. Diagn Pathol 2014; 9:10. [PMID: 24443792 PMCID: PMC3943513 DOI: 10.1186/1746-1596-9-10] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2013] [Accepted: 01/05/2014] [Indexed: 11/29/2022] Open
Abstract
Esthesioneuroblastoma is an uncommon tumour of neuroectodermal origin. The authors describe a rare presentation of an atypical esthesioneuroblastoma invading oral cavity. The clinical presentation, aetiology, diagnosis, and management of this condition are discussed. The patient developed significant swelling in the right anterosuperior alveolar mucosa and had moderate tooth mobility. Conventional x-rays and computed tomography revealed a large osteolytic lesion, with imprecise limits. Histological findings along with immunohistochemical staining results and clinical features led to the diagnosis of high-grade esthesioneuroblastoma. Local recurrences and neck metastasis were detected. The rare oral findings produced delayed in diagnosis which may lead to a compromise in planning and execution of further radical management and thus a poor prognosis.
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Affiliation(s)
- Sandra Ventorin von Zeidler
- Department of Pathology, Federal University of Espírito Santo, Piratininga n,180/602, Praia da Costa, Vila Velha - ES, 29101-220 Vitória, Brazil.
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Low-Grade Esthesioneuroblastoma Presenting as SIADH: A Review of Atypical Manifestations. Case Rep Otolaryngol 2012; 2012:582180. [PMID: 23259127 PMCID: PMC3521414 DOI: 10.1155/2012/582180] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2012] [Accepted: 11/08/2012] [Indexed: 11/24/2022] Open
Abstract
Esthesioneuroblastoma (ENB) is a neuroendocrine tumor that typically manifests as advanced stage malignancy in the superior nasal cavity. The hallmark symptoms include nasal obstruction and epistaxis, which result from local tissue invasion. Atypical clinical features can also arise and must be considered when diagnosing and treating ENB. These can include origin in an ectopic location, unusual presenting symptoms, and associated paraneoplastic syndromes. The case described here reports a nasal cavity ENB with atypical clinical features that occurred in a young female. Her tumor was low grade, appeared to arise primarily from the middle nasal cavity, and presented as syndrome of inappropriate antidiuretic hormone (SIADH). She also became pregnant shortly after diagnosis, which had implications on her surgical management. We review the atypical features that uncommonly occur with ENB and the clinical considerations that arise from these unusual characteristics.
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Aggressive olfactory neuroblastoma invading the oral cavity: report of a rare case and review of the literature. J Oral Maxillofac Surg 2012; 70:e252-7. [PMID: 22374068 DOI: 10.1016/j.joms.2011.11.020] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2011] [Revised: 11/17/2011] [Accepted: 11/17/2011] [Indexed: 11/23/2022]
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Kane AJ, Sughrue ME, Rutkowski MJ, Aranda D, Mills SA, Buencamino R, Fang S, Barani IJ, Parsa AT. Posttreatment prognosis of patients with esthesioneuroblastoma. J Neurosurg 2010; 113:340-51. [PMID: 20345216 DOI: 10.3171/2010.2.jns091897] [Citation(s) in RCA: 65] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECT There is no Class I evidence to guide the appropriate management of esthesioneuroblastoma (EN). Most data currently guiding treatment come from small- or modest-sized series gathered at individual centers that have concluded that surgery with radiotherapy is the preferred treatment. In this study, the authors summarize the published literature on treatment outcomes in patients with EN. The objective was to ascertain what variables predict prognosis in these patients and to determine the relative effect of different therapies. METHODS The authors identified 205 published studies containing treatment outcomes for surgery, radiotherapy, chemotherapy, or multimodal treatment. Using Kaplan-Meier analysis, the survival of patients who received surgery was compared with that in those who received surgery and radiotherapy. Additionally, Kadish staging was compared with low- and high-grade Hyams criteria to assess for subgroup prognostic significance in survival differences. RESULTS Nine hundred fifty-six patients met the inclusion criteria, with a median follow-up time of 3 years. Kaplan-Meier analysis demonstrated no difference in survival between patients who underwent surgery alone and those who underwent surgery plus radiotherapy at 5 years (78 vs 75%) or 10 years (67 vs 61%, respectively) (p = 0.3). Univariate analysis demonstrated worse survival in cases involving Kadish Grade C tumors, Hyams Grade 3 and 4 tumors, and in patients older than 65 years of age. Multivariate analysis demonstrated that Hyams Grade 3 and 4 lesions carried significant risk (proportional hazard = 4.83, p < 0.001) with 5- and 10-year survival of 47 and 31%. CONCLUSIONS A biopsy should always be obtained in cases suspected of EN because histology is a strong prognostic indicator and will help guide appropriate treatment. Unimodal surgery and combined surgery/radiotherapy appear to be of equivalent efficacy with respect to survival in patients with EN. Chemotherapy should be considered in high-grade EN.
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Affiliation(s)
- Ari J Kane
- Department of Neurological Surgery, University of California, San Francisco, California 94143, USA
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Kodama S, Kawano T, Suzuki M. Endoscopic transnasal resection of ectopic esthesioneuroblastoma in the pterygopalatine fossa: technical case report. Neurosurgery 2010; 65:E112-3; discussion E113. [PMID: 19935009 DOI: 10.1227/01.neu.0000346268.69786.88] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE Esthesioneuroblastoma is a rare, malignant neoplasm arising from the olfactory neuroepithelium in the upper nasal cavity. Even more rare is ectopic esthesioneuroblastoma developing from the region outside the olfactory epithelium. In addition, tumors occurring in the pterygopalatine fossa (PPF) are uncommon, and the endoscopic transnasal approach for the resection of malignant tumors in this region is also uncommon. CLINICAL PRESENTATION We describe an esthesioneuroblastoma arising from the left maxillary sinus and PPF. The tumor was resected using the endoscopic transnasal approach, followed by treatment with radiotherapy. The patient showed no evidence of recurrence 12 months postoperatively. TECHNIQUE The endoscopic transnasal approach could be successfully used for the complete removal of malignant tumors in the PPF. CONCLUSION The PPF is an anatomic area that is difficult to access. The endoscopic transnasal approach improves access and visualization; it also has the potential to reduce complications compared with the open approach. The endoscopic transnasal approach might become the treatment of choice for malignant tumors in the PPF.
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Affiliation(s)
- Satoru Kodama
- Department of Otolaryngology, Oita University Faculty of Medicine, Oita, Japan.
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Primary olfactory neuroblastoma originating from the posterior nasal septum. Otolaryngol Head Neck Surg 2010; 142:776-7.e1. [PMID: 20416476 DOI: 10.1016/j.otohns.2009.10.030] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2009] [Revised: 10/06/2009] [Accepted: 10/20/2009] [Indexed: 11/23/2022]
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Pagni F, Di Bella C, Bono F, Zoldan MC, Faravelli A. A 37-year-old woman with epistaxis [corrected] and unilateral nasal obstruction. Neuropathology 2008; 27:609-11. [PMID: 18021385 DOI: 10.1111/j.1440-1789.2007.00840.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Fabio Pagni
- Department of Pathology, Azienda Ospedaliera Ospedale Civile di Vimercate- Presidio di Desio, Desio, Unversità degli Studi di Milano Bicocca, Italy.
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