Esthesioneuroblastoma with unusual metastasis to T10 vertebra: case report and review of the literature
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Tarih
2011
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Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Estezyonöroblastom olfaktuar epitelden köken alan nadir görülen malign bir tümördür. 52 yaşındaki erkek hasta kliniğimize 3 aydır devam eden ilerleyici burun tıkanıklığı, burun kanaması ve nazal radikste kitle ile başvurdu. Rinoskopik muayenede her iki nazal kavitede polipoid kitle görüldü ve lokal anestezi ile biyopsi yapıldı. Histopatolojik analiz sonucunda estezyonöroblastom tanısı konuldu. Tümör Kadish evre B olarak değerlendirildi. Endoskopik endonazal ve lateral rinotomi ile yaklaşımları ile kitle eksizyonu yapıldı. Postoperatif radyoterapi uygulandı. Takiplerinde cerrahiden 10 ay sonra submandibuler lenf nodu metastazı saptandı ve hastaya bilateral tip 3 modifiye radikal boyun diseksiyonu yapıldı ve sonrasında radyoterapi uygulandı. Cerrahiden 12 ay sonra ise T10 vertebrada uzak metastaz saptandı. Hastanın uzak metastazı olduğu halde primer bölgede rekürrens saptanmadı. Sonuç olarak estezyonöroblastomalarda lokal nüksler sık olduğu için hastaların dikkatli bir şekilde takip edilmeleri gereklidir ve aynı zamanda lokal rekürrens olmadan da uzak metastaz olabileceği de akılda tutulmalıdır.
Esthesioneuroblastoma is a rare malignant tumor orginating from the olfactory epithelium. A 52–year-old man admitted to our clinic with a 3 months history of progressive nasal obstruction, epistaxis and mass on the nasal radix. On rhinoscopy, a polypoid mass was seen in the both nasal cavity and we performed an intranasal biopsy with local anesthesia. On histopathologic analysis the tumor was identifed as an esthesioneuroblastoma. The tumor was classified as Kadish stage B. The mass was excised via bilateral endoscopic endonasal resection and lateral rhinotomy approach. Radiotherapy was performed postoperatively. During the follow up, submandibuler lymph node metastasis occured ten months after surgery. The patient underwent bilateral type III modified radical neck dissection followed by radiotherapy to the neck. Distant metastasis developed on the T 10 vertebra 12 months after the initial treatment. Although he had distant metastasis he was free of local recurrence 13 th month after surgery. In conclusion because of locoregional recurrences are common in esthesioneuroblastomas, patients must be followed carefully but also we have to remember that distant metastasis may appear without local recurrence.
Esthesioneuroblastoma is a rare malignant tumor orginating from the olfactory epithelium. A 52–year-old man admitted to our clinic with a 3 months history of progressive nasal obstruction, epistaxis and mass on the nasal radix. On rhinoscopy, a polypoid mass was seen in the both nasal cavity and we performed an intranasal biopsy with local anesthesia. On histopathologic analysis the tumor was identifed as an esthesioneuroblastoma. The tumor was classified as Kadish stage B. The mass was excised via bilateral endoscopic endonasal resection and lateral rhinotomy approach. Radiotherapy was performed postoperatively. During the follow up, submandibuler lymph node metastasis occured ten months after surgery. The patient underwent bilateral type III modified radical neck dissection followed by radiotherapy to the neck. Distant metastasis developed on the T 10 vertebra 12 months after the initial treatment. Although he had distant metastasis he was free of local recurrence 13 th month after surgery. In conclusion because of locoregional recurrences are common in esthesioneuroblastomas, patients must be followed carefully but also we have to remember that distant metastasis may appear without local recurrence.
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