Esthesioneuroblastoma: A case report of diffuse subdural recurrence and review of recently published studies

Abstract

SUMMARYEsthesioneuroblastoma 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.

Outcome and Prognostic Factors in Olfactory Neuroblastoma: A Rare Cancer Network Study

“…Local recurrence and/or distant progression remains the main problem in the management of ONB and can occur many years after initial diagnosis and treatment (14). Salvage treatment consists of surgery, surgery and postoperative RT, RT alone, palliative chemotherapy, or supportive care depending on the type of relapse and the initial treatment of the patient.…”

“…Using combined modality treatment, many series report good locoregional control (6,7,10,11); however, when negative surgical margins are obtained, adjuvant radiation therapy (RT) remains questionable according to some authors (12,13). The role of chemotherapy in the treatment of ONB is controversial, both postoperatively and before resection (14)(15)(16)(17)(18)(19)(20).…”

Esthesioneuroblastoma presenting as tooth pain

“…Neoadjuvant chemotherapy has been used in advanced disease and where complete resection is not possible, with cyclophosphamide, vincristine ifosphamide, etoposide and cisplatin combined with preoperative radiotherapy. [ 11 ]…”

Esthesioneuroblastoma

“…S-100 protein is helpful as it identifies sustentacular cells in better differentiated tumors with paragangliomatous features. The Hyams grading system is based on preservation of lobular architecture, mitotic index, nuclear polymorphism, fibrillary matrix, rosettes and necrosis 6 . Almost all these features were found in our specimen.…”