Esthesioneuroblastoma overview

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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

Esthesioneuroblastoma, also known as olfactory neuroblastoma, is a rare form of cancer involving nasal cavity and believed to arise from the olfactory epithelium. It can cause loss of vision, and taste.[1] Esthesioneuroblastomas are undifferentiated tumors of neuroectodermal origin derived from the olfactory epithelium. The tumor cells are mitotically active and are the precursor cells that develop into sustentacular and neuronal cells. They usually present as a soft tissue mass in the superior olfactory recess involving the anterior and middle ethmoid air-cells on one side and extending through the cribriform plate into the anterior cranial fossa.[2]

Historical Perspective

Esthesioneuroblastoma was first discovered by Berger and Luc, in 1924.[3]

Classification

Based on the duration of symptoms, esthesioneuroblastoma may be classified into two subtypes neuroblastoma proper and neuroendocrine carcinomas.[4]

Pathophysiology

Genes involved in the pathogenesis of esthesioneuroblastoma include chromosomal gains in 7q11 and 20q and deletions in 2q, 5q, 6p, 6q, and 18q. On gross pathology, soft and hemorrhagic, polypoid appearance, and rich and fragile vascular supply of the tumor are characteristic findings of esthesioneuroblastoma. On microscopic histopathological analysis, arrangements of cells into rosettes or pseudorosettes are characteristic findings of esthesioneuroblastoma.[5][6][7][8][9][10][11]

Causes

The cause of esthesioneuroblastoma has not been identified. However, the proposed sources of origin include autonomic ganglia in the nasal mucosa, sphenopalatine ganglion, ectodermal olfactory placode, and olfactory epithelium.

Differential Diagnosis

Esthesioneuroblastoma must be differentiated from other tumors with similar histological appearance, such as lymphoma, Ewing sarcoma, melanoma, olfactory/ other [rhabdomyosarcoma or Merkel cell carcinoma], neuroblastoma, and small cell carcinoma. Distinguishing esthesioneuroblastomas from the other tumors is of paramount importance because the tumors respond differently to various treatment modalities.[5][12]

Epidemiology and Demographics

The incidence of esthesioneuroblastoma is approximately 0.4 per 100,000 individuals worldwide. Esthesioneuroblastoma can present in a wide range of age groups; however, it is mostly noted in a bimodal distribution, occurring most frequently in the second and sixth decades of life. There is no racial predilection to the esthesioneuroblastoma.[13][5]

Risk Factors

Screening

According to the United States Preventive Services Task Force, screening for esthesioneuroblastoma is not recommended.[14]

Natural History, Complications, and Prognosis

Staging

According to a staging system by Kadish, there are four stages of esthesioneuroblastoma based upon the extent of the primary tumor and lymph node or distant metastases. In 1992, Dulguerov and Calceterra proposed a classification based on the tumor, node, metastasis (TNM) system, predicted on CT and MRI findings that can be identified before treatment.[15][16][17]

History and Symptoms

Physical Examination

Laboratory Findings

CT

MRI

Other Imaging Studies

Other Diagnostic Studies

Medical Therapy

Primary Prevention

Secondary Prevention

Esthesioneuroblastoma is a rare form of cancer involving nasal cavity and believed to arise from the olfactory epithelium. The tissue of origin is not yet well characterized.

References

  1. Esthesioneuroblastoma. Wikipedia(2015) https://en.wikipedia.org/wiki/Esthesioneuroblastoma Accessed on January 26, 2016
  2. Barnes, Leon. Pathology and genetics of head and neck tumours. Lyon: IARC Press, 2005. Print.
  3. Broich G, Pagliari A, Ottaviani F (1997). "Esthesioneuroblastoma: a general review of the cases published since the discovery of the tumour in 1924". Anticancer Res. 17 (4A): 2683–706. PMID 9252701.
  4. Min KW (1995). "Usefulness of electron microscopy in the diagnosis of "small" round cell tumors of the sinonasal region". Ultrastruct Pathol. 19 (5): 347–63. PMID 7483011.
  5. 5.0 5.1 5.2 Esthesioneuroblastoma. Radiopedia(2015) http://radiopaedia.org/articles/olfactory-neuroblastoma Accessed on January 25, 2016
  6. Esthesioneuroblastoma. Libre pathology(2015) http://librepathology.org/wiki/index.php/Olfactory_neuroblastoma Accessed on January 25, 2015
  7. Hyams, V. J. (1988). Tumors of the upper respiratory tract and ear. Washington, D.C.: Armed Forces Institute of Pathology.
  8. Hirose T, Scheithauer BW, Lopes MB, Gerber HA, Altermatt HJ, Harner SG; et al. (1995). "Olfactory neuroblastoma. An immunohistochemical, ultrastructural, and flow cytometric study". Cancer. 76 (1): 4–19. PMID 8630875.
  9. Guled M, Myllykangas S, Frierson HF, Mills SE, Knuutila S, Stelow EB (2008). "Array comparative genomic hybridization analysis of olfactory neuroblastoma". Mod Pathol. 21 (6): 770–8. doi:10.1038/modpathol.2008.57. PMID 18408657.
  10. Mhawech P, Berczy M, Assaly M, Herrmann F, Bouzourene H, Allal AS; et al. (2004). "Human achaete-scute homologue (hASH1) mRNA level as a diagnostic marker to distinguish esthesioneuroblastoma from poorly differentiated tumors arising in the sinonasal tract". Am J Clin Pathol. 122 (1): 100–5. doi:10.1309/QD0K-9Q1J-BH6B-5GQQ. PMID 15272537.
  11. Carney ME, O'Reilly RC, Sholevar B, Buiakova OI, Lowry LD, Keane WM; et al. (1995). "Expression of the human Achaete-scute 1 gene in olfactory neuroblastoma (esthesioneuroblastoma)". J Neurooncol. 26 (1): 35–43. PMID 8583243.
  12. Argani P, Perez-Ordoñez B, Xiao H, Caruana SM, Huvos AG, Ladanyi M (1998). "Olfactory neuroblastoma is not related to the Ewing family of tumors: absence of EWS/FLI1 gene fusion and MIC2 expression". Am J Surg Pathol. 22 (4): 391–8. PMID 9580174.
  13. 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.
  14. http://www.uspreventiveservicestaskforce.org/BrowseRec/Search?s=esthesioneuroblastoma Accessed on December 26, 2016.
  15. Kadish S, Goodman M, Wang CC (1976). "Olfactory neuroblastoma. A clinical analysis of 17 cases". Cancer. 37 (3): 1571–6. PMID 1260676.
  16. Morita A, Ebersold MJ, Olsen KD, Foote RL, Lewis JE, Quast LM (1993). "Esthesioneuroblastoma: prognosis and management". Neurosurgery. 32 (5): 706–14, discussion 714-5. PMID 8492845.
  17. Dulguerov P, Calcaterra T (1992). "Esthesioneuroblastoma: the UCLA experience 1970-1990". Laryngoscope. 102 (8): 843–9. PMID 1495347.

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