Department of ENT, Ghurki Trust and Teaching Hospital, Lahore, Pakistan.
4th Year MBBS Student, Lahore Medical and Dental College, Lahore, Pakistan.
J Pak Med Assoc. 2024 Jul;74(7):1370-1373. doi: 10.47391/JPMA.10735.
Olfactory neuroblastoma is a rare malignant tumour arising from the olfactory nerve and extending into the nasal cavity. In this case report, the case of a 42-year-old male is presented. The patient had a two-month history of progressive nasal blockage and episodes of epistaxis. No complaint of anosmia or facial pain was reported. All the necessary examinations were performed. Upon investigation, the CT scan and MRI showed a polypoid mass involving the right maxillary sinus, eroding the medial wall and expanding into the osteo-meatal complex. The diagnosis of olfactory neuroblastoma was confirmed through histopathological examination and further validated by immunohistochemistry as it was positive for synaptophysin, chromogranin, gamma enolase, and neurofilament. On staging, the tumour was Kadish B. The mass was excised by lateral rhinotomy. The patient was kept on radiotherapy and was free from recurrence upon follow-up 10 months later. It was concluded that based on the analysis of findings related to olfactory neuroblastomas, clinicians should contemplate the possibility of an ONB when radiographic images depict a dumbbell-shaped mass within the nasal cavity, accompanied by peritumoural cysts. Using a multimodal treatment approach is advisable.
嗅神经母细胞瘤是一种罕见的恶性肿瘤,起源于嗅神经并延伸至鼻腔。本病例报告介绍了一例 42 岁男性患者。患者有两个月的渐进性鼻塞和鼻出血病史。无嗅觉丧失或面部疼痛的主诉。进行了所有必要的检查。调查显示,CT 扫描和 MRI 显示一个息肉状肿块累及右侧上颌窦,侵蚀内侧壁并扩展到骨-鼻甲复合体。通过组织病理学检查和免疫组织化学检查(Synaptophysin、chromogranin、gamma enolase 和 neurofilament 阳性)确诊为嗅神经母细胞瘤。分期时,肿瘤为 Kadish B 期。通过侧鼻切开术切除肿块。患者接受了放疗,随访 10 个月后无复发。结论是,根据嗅神经母细胞瘤相关发现的分析,当影像学图像显示鼻腔内呈哑铃状肿块,并伴有肿瘤周围囊肿时,临床医生应考虑到发生嗅神经母细胞瘤的可能性。采用多模态治疗方法是明智的。