Akgul Mehmet Hüseyin, Gezen Ferruh, Uzunlar Ali Kemal
Kırıkkale University Medical Faculty, Department of Neurosurgery, Kirikkale, Turkey.
Medeniyet University Medical Faculty Department of Neurosurgery, Istanbul, Turkey.
Int J Surg Case Rep. 2016;27:70-73. doi: 10.1016/j.ijscr.2016.06.015. Epub 2016 Jul 30.
Esthesioneuroblastoma accounted for only 6% of the malignant nasal cavity neoplasms (ENB) is a rare tumor which originates from the olfactory epithelium. ENB's are locally agresive and can metastasize by lymphatic and hematogenous routes. A patient with the mass on the nasal dorsum was reported in this article.
A 52-year-old-man admitted to the hospital with a 3 months history of progressive nasal obstruction, epistaxis and mass on the nasal dorsum. On rhinoscopy, a polypoid mass was seen in the both nasal cavity and intranasal biopsy with local anesthesia was performed. Histopathologic diagnosis of the tumor was Kadish stage B esthesioneuroblastoma. Tumor was excised by using bilateral endoscopic endonasal resection and lateral rhinotomy approach and paranasal radiotherapy performed postoperatively. Ten months after surgery, neck metastasis was occured and patient was underwent neck dissection. Twenteeth months after initial treatment, distant metastasis was identified on the T 10 vertebra and following the cranial and spinal radiotherapy to the neck he was free of local recurrence at follow up 13 months after surgery.
It has been known that the metastasis of the ENB to the spinal cord is an uncommon event, and it occurs often years after initial diagnosis. MRI scan is helpful for making the diagnosis, and surgery is the treatment of choice for obtaining diagnostic tissue and debulking the tumor. Radiotherapy is also a mainstay of postoperative treatment.
嗅神经母细胞瘤仅占鼻腔恶性肿瘤的6%，是一种起源于嗅上皮的罕见肿瘤。嗅神经母细胞瘤具有局部侵袭性，可通过淋巴和血行途径转移。本文报道了一名鼻背部有肿物的患者。
一名52岁男性因进行性鼻塞、鼻出血和鼻背部肿物3个月病史入院。鼻内镜检查时，在双侧鼻腔均可见一息肉样肿物，并在局部麻醉下进行了鼻内活检。肿瘤的组织病理学诊断为卡迪什B期嗅神经母细胞瘤。采用双侧鼻内镜鼻内切除术和鼻侧切开术切除肿瘤，并在术后进行鼻旁放疗。术后10个月发生颈部转移，患者接受了颈部清扫术。初始治疗20个月后，在第10胸椎发现远处转移，在对颈部进行颅脑和脊髓放疗后，术后13个月随访时未见局部复发。
已知嗅神经母细胞瘤转移至脊髓是一种罕见事件，通常发生在初始诊断多年后。磁共振成像扫描有助于诊断，手术是获取诊断组织和切除肿瘤的首选治疗方法。放疗也是术后治疗的主要手段。
