Rare case of mortality after hemorrhagic property of esthesioneuroblastoma

Todd Furr, Brandon Grodman, Jeremy Heffernan

Abstract


Esthesioneuroblastoma is a tumor arising from olfactory neuroepithelium with an incidence of four per million. This case presents a rare nasal cavity neoplasm with hemorrhagic properties that may lead to significant sequelae. We present a 69-year-old male patient who presented with worsening altered mental status over the past 6-7 months. His Glasgow coma scale was a nine, showing a large mass centered at the cribriform plate with extension intracranially, sinonasal cavity, and bilateral orbits on diagnostics. Bifrontal craniotomy was performed one day after admission with resection of the tumor in the cranial fossa and intranasally, and decompression of the brainstem, frontal lobes, and third ventricle. After surgery, the patient was managed in the intensive care unit but continued to deteriorate. He was confirmed to have no meaningful brain activity and eventually deceased seven days after admission. Depending on the tumor stage, esthesioneuroblastoma can have a favorable prognosis with proper therapies. Different surgical techniques for ENB lead to the question of which therapeutic modality is the best because of the tumor's gross hemorrhagic properties. With adjunctive radiation therapy and/or chemotherapy, more research can bring light to proper surgical techniques.

Keywords


esthesioneuroblastoma; olfactory neuroblastoma; postoperative hemorrhage; frontal craniotomy; Hyams grading system; modified Kadish staging system

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References


Fiani B, Quadri SA, Cathel A, et al. Esthesioneuroblastoma: A Comprehensive Review of Diagnosis, Management, and Current Treatment Options. World Neurosurg. 2019;126:194-211. doi: 10.1016/j.wneu.2019.03.014. PMID: 30862589.

Berger L, Luc R, Richard D. L’esthesioneuroepitheliome Olfactif, Bull Assoc Fr Etud Cancer. 1924; (13):410-421.

Kuan EC, Nasser HB, Carey RM, et al. A Population-Based Analysis of Nodal Metastases in Esthesioneuroblastomas of the Sinonasal Tract. Laryngoscope. 2019;129(5):1025-1029. doi: 10.1002/lary.27301. PMID: 30194694.

Bak M, Wein RO. Esthesioneuroblastoma: a contemporary review of diagnosis and management. Hematol Oncol Clin North Am. 2012;26(6):1185-207. doi: 10.1016/j.hoc.2012.08.005. PMID: 23116576.

Kadish S, Goodman M, Wang CC. Olfactory neuroblastoma. A clinical analysis of 17 cases. Cancer. 1976;37(3):1571-6. doi: 10.1002/1097-0142(197603)37:3<1571::aid-cncr2820370347>3.0.co;2-l. PMID: 1260676.

Rostomily RC, Elias M, Deng M, et al. Clinical utility of somatostatin receptor scintigraphic imaging (octreoscan) in esthesioneuroblastoma: a case study and survey of somatostatin receptor subtype expression. Head Neck. 2006;28(4):305-12. doi: 10.1002/hed.20356. PMID: 16470879.

Hyams VJ, Batsakis JG, Michaels L. Tumors of the upper respiratory tract and ear. In: Atlas of Tumor Pathology, Armed Forces Institute of Pathology. Fascicle 25. Washington, DC, 1988, p. 247.

Wang EW, Zanation AM, Gardner PA, et al. ICAR: endoscopic skull-base surgery. Int Forum Allergy Rhinol. 2019;9(S3):S145-S365. doi: 10.1002/alr.22326. PMID: 31329374.

Dulguerov P, Allal AS, Calcaterra TC. Esthesioneuroblastoma: a meta-analysis and review. Lancet Oncol. 2001;2(11):683-90. doi: 10.1016/S1470-2045(01)00558-7. PMID: 11902539.

Gandhoke CS, Dewan A, Gupta D, et al. A rare case report of mixed olfactory neuroblastoma: Carcinoma with review of literature. Surg Neurol Int. 2017;8:83. doi: 10.4103/sni.sni_30_17. PMID: 28607817; PMCID: PMC5461572..

Jain S, Sen K. Occult hemoptysis: a rare case of esthesioneuroblastoma. Int J Otorhinolaryngol Head Neck Surg. 2020;6(8):1542-1545. 10.18203/issn.2454-5929.ijohns20203212.




DOI: http://dx.doi.org/10.22551/2023.41.1004.10269

Copyright (c) 2023 Todd Furr, Brandon Grodman, Jeremy Heffernan

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