Esthesioneuroblastoma: The Johns Hopkins experience

Abstract

Background Esthesioneuroblastoma (ENB) is an uncommon malignant neoplasm of the upper nasal cavity. Therapeutic management approaches for this neoplasm lack uniformity and there is no universally accepted staging system. Methods A retrospective review of 27 patients with histologically confirmed ENB managed at The Johns Hopkins Hospital. Results Eighty‐five percent of patients had surgical resection as part of their disease management. Complete surgical resection was achieved in 62% of patients who had a craniofacial resection. Eighty percent of patients with negative surgical margins remain with no evidence of disease, with a median follow‐up of 5.6 years. Adjuvant radiation therapy was beneficial to 62% of patients with positive surgical margins. Clinical responses were observed with cisplatin‐ and etoposide‐containing chemotherapy regimens in patients with advanced disease. A revised staging system based on our experience is proposed. Conclusions ENB is best managed by craniofacial resection with complete tumor resection. Adjuvant radiation therapy is warranted in patients that remain with positive histologic margins of resection. Chemotherapy with cisplatin‐ and etoposide‐containing regimens may be useful for palliation of advanced disease. © 2000 John Wiley & Sons, Inc. Head Neck 22: 550–558, 2000

Esthesioneuroblastoma: A case with prolonged disease control

“…The types of schedules and the optimal duration of treatment have also not been determined. Analogous to other related neuroendocrine tumors, cisplatin-based schedules (mainly associated with etoposide) are most frequently used [3,[36][37][38] . The use of non-platinum combinations such as irinotecan + docetaxel, [38] or doxorubicin + ifosfamide + vincristine [40] have also been reported.…”

Esthesioneuroblastoma: An Update on the Massachusetts Eye and Ear Infirmary and Massachusetts General Hospital Experience with Craniofacial Resection, Proton Beam Radiation, and Chemotherapy

“…4,5,14,[19][20][21][22] Furthermore, cervical lymph node involvement has been established as a negative prognostic indicator. Koka and colleagues reported a 0% 2-year survival rate for patients with regional metastases.…”

“…4,5 Since its initial description in 1924, multiple institutions have developed treatment strategies that use various combinations of surgery, radiation therapy, and chemotherapy. 1,2,[6][7][8][9][10][11][12][13][14] Although no definitive regimen has been established, analysis of this collective experience demonstrates that multimodality therapy, particularly surgery followed by radiation, achieves the highest cure rates.…”

Estudio retrospectivo de 11 casos de estesioneuroblastomas tratados en el Hospital Santa Creu i Sant Pau entre los años 2000 y 2008 más revisión de la literatura

“…En 4 se hablaban sobre las diferentes técnicas quirúrgicas, sobretodo resección craneofacial y endoscopia 15,[21][22]60 . También se incluyeron 5 artículos que trataban sobre datos anatom opatológicos 12,23,43,45,52 , 3 sobre la genética del ENB 31,54,56 , y 3 artículos históricos que fueron considerados interesantes para incluir 3,26,29 . Sobre la controversia que existe sobre el diagnóstico diferencial entre ENB y carcinoma indiferenciado, varios artículos hablan sobre el error diagnóstico que se establece cuando se considera que es un ENB cuando en realidad es un carcinoma indiferenciado.…”