Esthesioneyroblastoma. Retrospective analysis of 10 observations

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Abstract

Background. Esthesioneyroblastoma is a rare malignant tumor arising from olfactory neuroepithelium of the nasal cavity. It is an aggressive local tumor. It accounts for 3 to 6% of cases of nasal and sinus cancer. Occurs at any age. Due to the rarity of the disease, there are no uniform standards of treatment. A multimodal and interdisciplinary approach is recommended.

Aim. To present the results of a retrospective study of patients with esthesioneuroblastoma.

Materials and methods. The retrospective study was carried out using the database of departments of radionuclide diagnostics of Nuclear Medicine Centres from 2012 to 2022. Ten patients with histologically confirmed diagnosis of esthesioneyroblastoma were identified.

Results. Age of patients from 29 to 67 years, median – 51 years. Men and women – equal. The clinical picture was dominated by a sense of nasal congestion and various nose impairments – 8 and 7 patients. The tumor was more often confined to the left side of the nose. Computer tomography (CT), magnetic resonance imaging and positron emission tomography combined with CT (PET/CT) were used for diagnosis, estimation of tumor process prevalence and outpatient observation. Stage A by Kadish was identified in 2 cases, and stage B – in 1 patient. Stage C – 6 patients predominated. D was diagnosed in 1 patient. The use of PET/CT clarifies the primary stage, the effect of therapy, provides disease control during dynamic observation. The SUVmax median for primary tumor was 7.43 (4.3–19.1). A multi-modal approach is used to treat esthesioneuroblastoma. The surgical method is performed by 4 patients with subsequent radiation therapy. Radiation therapy was carried out at the first stage of 3 patients, the total focal dose was 66 Gy. Polychemotherapy followed by radiotherapy was used in 3 cases. Duration of observation ranged from 8 to 108 months, median – 47.5 months.

Conclusion. Esthesioneyroblastoma is a rare malignant nasal tumor. The peak of the disease falls on 50–70 years. No gender differences have been identified. The main clinical symptoms are nasal congestion – 8 patients and various smelling disorders – 7 patients. PET/CT is the main imaging method in the diagnostic, evaluation and observation phases. In this case, most often (6 patients) is determined stage C by Kadish.

About the authors

Nikolai A. Ognerubov

Derzhavin Tambov State University

Author for correspondence.
Email: ognerubov_n.a@mail.ru
ORCID iD: 0000-0003-4045-1247

D. Sci. (Med.), Cand. Sci. (of Law), Prof.

Russian Federation, Tambov

Tatiana S. Antipova

PET-Technology

Email: antipovats@gmail.com
ORCID iD: 0000-0003-4165-8397

Doctor

Russian Federation, Tambov

Marina A. Ognerubova

Tambov Regional Oncological Clinical Dispensary

Email: gostyaeva.m.a@mail.ru
ORCID iD: 0000-0003-0576-5451

Oncologist

Russian Federation, Tambov

References

Supplementary files

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1. JATS XML
2. Figure 1. Patient T., 63 years old. On MIP PET, axial, sagittal CT and combined PET/CT projections, against the background of an unevenly thickened mucous membrane of the cells of the ethmoid labyrinth of the turbinates, maxillary and frontal sinuses, hypermetabolic areas with increased accumulation of radiopharmaceuticals, SUVmax 19.1, are determined. In the left lateral mass of the sacrum SII there is a focus of increased fixation of the radiopharmaceutical without structural changes, SUVmax 19.6.

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3. Figure 2. Patient M., 67 years old. On MIP PET, axial and sagittal CT and PET / CT projections in the nasal cavity on the left and nasopharynx, cells of the cribriform labyrinth, a volumetric formation of soft tissue density is determined, with fixation of radiopharmaceuticals, 85 × 38 × 73 mm in size. There is a fuzziness of the contours of the medial wall of the left orbit and the left maxillary sinus, cells of the ethmoid labyrinth, nasal septum, turbinates (destruction). Education extends into the anterior cranial fossa through the cribriform plate.

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4. Figure 3. Patient M., 67 years old. 8 weeks after the end of radiation therapy, SOD 66 Gy. Partial tumor regression. On MIP PET, PET/CT on axial and sagittal CT and PET/CT projections in the nasal cavity, there is an irregularly shaped volumetric formation with clear uneven contours, up to 51 × 31 × 50 mm in size, with hypermetabolism FDG SUVmax 3.81, with spread on the cells of the ethmoid bone, nasopharynx and anterior cranial fossa.

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