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Neurocirugía  2011 

Estudio retrospectivo de 11 casos de estesioneuroblastomas tratados en el Hospital Santa Creu i Sant Pau entre los a?os 2000 y 2008 más revisión de la literatura

DOI: 10.4321/S1130-14732011000500002

Keywords: olfactory esthesioneuroblastoma, surgery, treatment outcome, survival, review.

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Abstract:

introduction. esthesioneuroblastoma (enb) is a very uncommon malignant tumor with a neuroectodermal origin that usually involves the anterior cranial fossa and nasal cavity. objectives. to review our experience in the management of enb and assess the validity of the histopathological diagnosis, modality of treatment and prognostic factors of the disease comparing our findings with the literature. methods. a retrospective study of 11 cases with the diagnosis of esthesioneuroblastoma treated in our hospital between 2000 and 2008. statistical analysis was performed in search for prognostic factors. the bibliography about enb published between 1990 and 2009 was reviewed results. there were 3 women and 8 men, with a mean age of 42 years old (range 20-71y). their symptoms upon admission were nasal obstruction (81%), epistaxis (27%), visual loss (18%), headache and others. according to the kadish stage, 2 were stage b and 9 were stage c. dulguerov and calcaterra classification was also used: 2 were t2, 3 were t3 and 6 were t4. the hystopathological result according to the hyams classification was: 2 cases in stage i, 4 in stage ii, 3 in stage iii and 2 in stage iv. the two cases classified in stage iv changed the diagnosis to undifferenciate tumor in the second biopsy. a subcranial approach was performed in 8 cases combined with endonasal endoscopy to confirm the total removal, followed by radiotherapy in all and chemotherapy in one case, resulting on 62% (5 patients) being alive without disease, 12,5% (1 p) alive with disease, and 25% (2 p) dead of disease. another patient was operated by a single endonasal endoscopic approach and a subtotal removal was achieved. this patient is alive without disease. the other 2 patients were treated by biopsy plus radiotherapy and chemotherapy, because they were considered unresectable, and one of them is alive with disease and the other one is dead of disease. radiotherapy was performed in all cases and chemotherapy in 5 cases. the hys

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