Endoscopic treatment of esthesioneuroblastoma

Abstract

Esthesioneuroblastoma is an uncommon malignant tumor of the nasal vault. Treatment consists of craniofacial resection. As endoscopic techniques have advanced, this approach has been recommended to avoid morbidity and to reduce costs. Aim To evaluate outcomes in patients with esthesioneuroblastoma treated by an endoscopic technique. Methods A prospective study of patients diagnosed with esthesioneuroblatoma and treated by an endoscopic technique. The literature over the past 20 years was reviewed for an update on the pathology. Results We present 4 patients, 3 males and 1 female, staged according to Kadish and Dulguerov. All were treated surgically with endoscopic techniques, followed by radiotherapy. One patient was also submitted to neck dissection and chemotherapy because of regional metastasis. There were no significant postoperative complications. The mean hospital stay was 3 days; one patient stayed in the ICU for 24 hours after surgery. Follow-up is recent; so far there are no recurrences. Conclusion Esthesioneuroblastoma is a potentially curable malignancy. Endoscopic techniques help reduce hospital costs and decrease the morbidity. Adequate margins of healthy tissue are obtained with endoscopic resection, as with craniofacial resection. The literature suggests that outcomes after endoscopic resection are similar to those of the conventional external approach.

Transnasal Endoscopic Surgery in Complex Treatment of Esthesioneuroblastoma in Children

“…Малое количество наблюдений не позволяет сделать вывод о целе-сообразности лучевого лечения у этой категории пациентов. Отдельные исследователи утверждают, что эндоназальное удаление опухоли на ранних стадиях не только положительно сказывается на качестве жизни, но и не ухудшает онкологического прогноза [1,11]. У 3 из 4 пациентов с распространением ЭНБ в полость черепа выполнено трансназальное эндоскопическое удаление опухоли, при котором в 2 случаях потребовалось проведение пластики дефекта твердой мозговой оболочки.…”

“…Опухоли полости носа, носоглотки, околоносовых пазух у детей состав-ляют не более 5% всех злокачественных опухолей детского возраста. На долю эстезионейробласто-мы (ЭНБ) в данном анатомическом регионе сре-ди всех злокачественных опухолей головы и шеи приходится 1-6% [1]. Опухоль одинаково часто выявляется у лиц обоего пола.…”

“…Этиопатогенез. В специальной литературе используют такие термины, как эстезионейробла-стома и ольфакторная нейробластома [1,3]. ЭНБ исходит из обонятельного нейроэпителия, кото-рый способен к регенерации в течение жизни.…”

Olfactory Neuroblastoma Treated by Minimally Invasive Endoscopic Resection and Postoperative Adjuvant Radiotherapy: A Representative Case and an Updated Review of the Literature

“…Other tumors, that should also be considered in the differential diagnosis, are paragangliomas, extramedullary plasmacytomas pituitary adenomas, extracranial meningiomas, mesenchymal chondrosarcomas and granulocytic sarcomas [2][3][4][5]10].…”

“…Given that late local and regional recurrence is considered to be quite common in esthesioneuroblastomas, the need for extended follow up (10,15 or even up to 20 years after initial treatment) is generally supported by the recent literature [3][4][5]. Both endoscopic/clinical examination and imaging studies are recommended on a regular basis.…”