Esthesioneuroblastoma natural history, complications and prognosis: Difference between revisions
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Esthesioneuroblastoma tumors display varying clinical behaviors ranging from indolent growth to highly aggressive invasion.<ref>Kane, Ari J., et al. "Posttreatment prognosis of patients with esthesioneuroblastoma: clinical article." Journal of neurosurgery 113.2 (2010): 340-351.</ref> The average delay between the appearance of the initial symptom and the diagnosis is six months, however diagnosis may be delayed for years in some cases. The delay is predictable because initial symptoms tend to be subtle and are frequently common, occurring also in nasal diseases, including allergic polypoid sinus disease or long-term rhinosinusitis.<ref name="pmid20453548">{{cite journal| author=Zhang M, Zhou L, Wang DH, Huang WT, Wang SY| title=Diagnosis and management of esthesioneuroblastoma. | journal=ORL J Otorhinolaryngol Relat Spec | year= 2010 | volume= 72 | issue= 2 | pages= 113-8 | pmid=20453548 | doi=10.1159/000278255 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20453548 }} </ref> Despite aggressive therapy, esthesioneuroblastoma has been noted to have a high local recurrence rate of approximately 50–60% with 10–62% presenting as metastatic cases and 20–30% of those cases involving the CNS. Once esthesioneuroblastoma cells invade the cribriform plate, they may spread to the anterior skull base, extend to the leptomeninges or brain parenchyma and can lead to drop metastasis anywhere in central neural axis.<ref name="ShirzadiDrazin2013">{{cite journal|last1=Shirzadi|first1=Ali S.|last2=Drazin|first2=Doniel G.|last3=Strickland|first3=Allison S.|last4=Bannykh|first4=Serguei I.|last5=Johnson|first5=J. Patrick|title=Vertebral Column Metastases from an Esthesioneuroblastoma: Chemotherapy, Radiation, and Resection for Recurrence with 15-Year Followup|journal=Case Reports in Surgery|volume=2013|year=2013|pages=1–8|issn=2090-6900|doi=10.1155/2013/107315}}</ref> | Esthesioneuroblastoma tumors display varying clinical behaviors ranging from indolent growth to highly aggressive invasion.<ref>Kane, Ari J., et al. "Posttreatment prognosis of patients with esthesioneuroblastoma: clinical article." Journal of neurosurgery 113.2 (2010): 340-351.</ref> The average delay between the appearance of the initial symptom and the diagnosis is six months, however diagnosis may be delayed for years in some cases. The delay is predictable because initial symptoms tend to be subtle and are frequently common, occurring also in nasal diseases, including allergic polypoid sinus disease or long-term rhinosinusitis.<ref name="pmid20453548">{{cite journal| author=Zhang M, Zhou L, Wang DH, Huang WT, Wang SY| title=Diagnosis and management of esthesioneuroblastoma. | journal=ORL J Otorhinolaryngol Relat Spec | year= 2010 | volume= 72 | issue= 2 | pages= 113-8 | pmid=20453548 | doi=10.1159/000278255 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20453548 }} </ref> Despite aggressive therapy, esthesioneuroblastoma has been noted to have a high local recurrence rate of approximately 50–60% with 10–62% presenting as metastatic cases and 20–30% of those cases involving the CNS. Once esthesioneuroblastoma cells invade the cribriform plate, they may spread to the anterior skull base, extend to the leptomeninges or brain parenchyma and can lead to drop metastasis anywhere in central neural axis.<ref name="ShirzadiDrazin2013">{{cite journal|last1=Shirzadi|first1=Ali S.|last2=Drazin|first2=Doniel G.|last3=Strickland|first3=Allison S.|last4=Bannykh|first4=Serguei I.|last5=Johnson|first5=J. Patrick|title=Vertebral Column Metastases from an Esthesioneuroblastoma: Chemotherapy, Radiation, and Resection for Recurrence with 15-Year Followup|journal=Case Reports in Surgery|volume=2013|year=2013|pages=1–8|issn=2090-6900|doi=10.1155/2013/107315}}</ref> | ||
==Complications== | ==Complications== | ||
==Prognosis== | ==Prognosis== | ||
*The prognosis depends on the magnitude of the disease on initial diagnosis. | |||
*Esthesioneuroblastomas often display varying biologic activity ranging from indolent growth, with patient survival exceeding twenty years, to a highly aggressive neoplasm capable of rapid widespread metastasis, with survival limited to a few months. | |||
*CNS metastasis is reported to have a survival expectancy of two years or less and is usually noted 0–10 years after the initial diagnosis. | |||
*Spinal metastasis of ENB is rare with only 28 documented cases involving the spine, spinal cord, or leptomeninges.<ref>Shaari, Christopher M., et al. "Central nervous system metastases from esthesioneuroblastoma." Otolaryngology--Head and Neck Surgery 114.6 (1996): 808-812.</ref> | |||
*The metastatic rate of esthesioneuroblastoma has been estimated to range from 10 to 62 percent. The most common site of metastatic disease is the cervical lymph nodes but metastatic disease has been found in the parotid, long bones, meninges, breast, lung, prostate, prostate, abdominal viscera, and pelvis. | |||
*The rate of local recurrence for this tumor after therapy is 57% with a survival rate of 56% at the end of five years. | |||
*Prognostic factors must be considered when determining the best treatment for esthesioneuroblasstoma. Murakami et al. reported that histological tumor grade and complete surgical resection are the two most important prognostic factors. Hwang et al. emphasized the importance of diagnosing the disease in an early stage and regular radiologic followups to detect disease recurrence, to improve prognosis.<ref name="ShirzadiDrazin2013">{{cite journal|last1=Shirzadi|first1=Ali S.|last2=Drazin|first2=Doniel G.|last3=Strickland|first3=Allison S.|last4=Bannykh|first4=Serguei I.|last5=Johnson|first5=J. Patrick|title=Vertebral Column Metastases from an Esthesioneuroblastoma: Chemotherapy, Radiation, and Resection for Recurrence with 15-Year Followup|journal=Case Reports in Surgery|volume=2013|year=2013|pages=1–8|issn=2090-6900|doi=10.1155/2013/107315}}</ref> | |||
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Revision as of 03:33, 27 January 2016
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Simrat Sarai, M.D. [2]
Overview
Natural History
Esthesioneuroblastoma tumors display varying clinical behaviors ranging from indolent growth to highly aggressive invasion.[1] The average delay between the appearance of the initial symptom and the diagnosis is six months, however diagnosis may be delayed for years in some cases. The delay is predictable because initial symptoms tend to be subtle and are frequently common, occurring also in nasal diseases, including allergic polypoid sinus disease or long-term rhinosinusitis.[2] Despite aggressive therapy, esthesioneuroblastoma has been noted to have a high local recurrence rate of approximately 50–60% with 10–62% presenting as metastatic cases and 20–30% of those cases involving the CNS. Once esthesioneuroblastoma cells invade the cribriform plate, they may spread to the anterior skull base, extend to the leptomeninges or brain parenchyma and can lead to drop metastasis anywhere in central neural axis.[3]
Complications
Prognosis
- The prognosis depends on the magnitude of the disease on initial diagnosis.
- Esthesioneuroblastomas often display varying biologic activity ranging from indolent growth, with patient survival exceeding twenty years, to a highly aggressive neoplasm capable of rapid widespread metastasis, with survival limited to a few months.
- CNS metastasis is reported to have a survival expectancy of two years or less and is usually noted 0–10 years after the initial diagnosis.
- Spinal metastasis of ENB is rare with only 28 documented cases involving the spine, spinal cord, or leptomeninges.[4]
- The metastatic rate of esthesioneuroblastoma has been estimated to range from 10 to 62 percent. The most common site of metastatic disease is the cervical lymph nodes but metastatic disease has been found in the parotid, long bones, meninges, breast, lung, prostate, prostate, abdominal viscera, and pelvis.
- The rate of local recurrence for this tumor after therapy is 57% with a survival rate of 56% at the end of five years.
- Prognostic factors must be considered when determining the best treatment for esthesioneuroblasstoma. Murakami et al. reported that histological tumor grade and complete surgical resection are the two most important prognostic factors. Hwang et al. emphasized the importance of diagnosing the disease in an early stage and regular radiologic followups to detect disease recurrence, to improve prognosis.[3]
Grade of the tumor | Ten-year survival |
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Grade of the tumor | Five-year survival |
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Treatment usually involves combined chemotherapy and/or radiotherapy with surgical excision. Prognosis is significantly affected by presence of distant metastases.
Metastasis | Five-year survival |
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References
- ↑ Kane, Ari J., et al. "Posttreatment prognosis of patients with esthesioneuroblastoma: clinical article." Journal of neurosurgery 113.2 (2010): 340-351.
- ↑ Zhang M, Zhou L, Wang DH, Huang WT, Wang SY (2010). "Diagnosis and management of esthesioneuroblastoma". ORL J Otorhinolaryngol Relat Spec. 72 (2): 113–8. doi:10.1159/000278255. PMID 20453548.
- ↑ 3.0 3.1 Shirzadi, Ali S.; Drazin, Doniel G.; Strickland, Allison S.; Bannykh, Serguei I.; Johnson, J. Patrick (2013). "Vertebral Column Metastases from an Esthesioneuroblastoma: Chemotherapy, Radiation, and Resection for Recurrence with 15-Year Followup". Case Reports in Surgery. 2013: 1–8. doi:10.1155/2013/107315. ISSN 2090-6900.
- ↑ Shaari, Christopher M., et al. "Central nervous system metastases from esthesioneuroblastoma." Otolaryngology--Head and Neck Surgery 114.6 (1996): 808-812.