Cantrell R W, Ghorayeb B Y, Fitz-Hugh G S
Ann Otol Rhinol Laryngol. 1977 Nov-Dec;86(6 Pt 1):760-5. doi: 10.1177/000348947708600608.
Esthesioneuroblastoma is a nasal tumor which arises from cells of neural crest origin. It is a difficult tumor to diagnose clinically and histopathologically. First described in 1924, approximately 160 cases have been reported with over 125 of these in the last 15 years. This reflects an increased awareness of the tumor by physicians rather than an icreased incidence. In the past 17 years, 12 cases of esthesioneuroblastoma have been treated at the Department of Otolaryngology and Maxillofacial Surgery of the University of Virginia Medical Center. Reviewing these cases and the literature leads us to make the following recommendations for diagnosis and treatment: The diagnosis of esthesioneuroblastoma can be made by 1) the clinician who suspects it in any patient with a nasal mass causing unilateral obstruction; 2) the finding of plexiform intercellular fibrils by light microscopy (rosettes and pseudorosettes are not as common as reported); 3) the finding of secretory granules and neurites by electron microscopy of the highly undifferentiated tumors; and 4) formaldehyde-fume-induced fluorescence. Combined therapy with preoperative irradiation followed by craniofacial resection of the tumor to include the cribriform plate is recommended. This treatment should result in a five-year survival in excess of 50% of patients.
嗅神经母细胞瘤是一种起源于神经嵴细胞的鼻腔肿瘤。它在临床和组织病理学上都很难诊断。1924年首次被描述，据报道约有160例，其中超过125例是在过去15年中报道的。这反映出医生对该肿瘤的认识有所提高，而非发病率上升。在过去17年里，弗吉尼亚大学医学中心耳鼻咽喉头颈外科治疗了12例嗅神经母细胞瘤。回顾这些病例及相关文献后，我们对诊断和治疗提出以下建议：嗅神经母细胞瘤的诊断可依据以下几点：1）临床医生在任何有导致单侧鼻塞的鼻腔肿物的患者中怀疑该病时；2）通过光学显微镜发现丛状细胞间纤维（菊形团和假菊形团不像报道的那么常见）；3）通过电子显微镜在高度未分化肿瘤中发现分泌颗粒和神经突；4）甲醛烟雾诱导荧光。建议采用术前放疗联合颅面肿瘤切除术，包括切除筛板。这种治疗方法应能使超过50%的患者存活五年。
