Обоснование. Эстезионейробластома представляет собой редкое злокачественное новообразование, возникающее из обонятельного нейроэпителия полости носа. Это агрессивная местно-распространенная опухоль. На ее долю приходится от 3 до 6% случаев рака полости носа и околоносовых пазух. Встречается в любом возрасте. В связи с редкостью заболевания единых стандартов лечения нет. Рекомендуются мультимодальный и междисциплинарный подход. Цель. Представить результаты ретроспективного исследования пациентов с эстезионейробластомой. Материалы и методы. Ретроспективное исследование проведено с использованием базы данных отделений радионуклидной диагностики Центров ядерной медицины с 2012 по 2022 г. Выявлено 10 пациентов с гистологически подтвержденным диагнозом эстезионейробластомы. Результаты. Возраст больных от 29 до 67 лет, медиана – 51 год. Мужчин и женщин – поровну. В клинической картине преобладали чувство заложенности носа и различные нарушения обоняния – 8 и 7 пациентов. Опухоль чаще локализовалась в левой половине носа. Для постановки диагноза, оценки распространенности опухолевого процесса и диспансерном наблюдении применяли компьютерную томографию (КТ), магнитно-резонансную томографию и позитронно-эмиссионную томографию, совмещенную с КТ (ПЭТ/КТ). Стадия А по Kadish выявлена в 2 случаях, а стадия В – у 1 пациента. Преобладала стадия С – 6 больных. Стадия D диагностирована у 1 пациента. Применение ПЭТ/КТ уточняет первичную стадию, эффект терапии, обеспечивает контроль болезни при динамическом наблюдении. Медиана SUVmax для первичной опухоли составила 7,43 (4,3–19,1). Для лечения эстезионейробластомы применяется мультимодальный подход. Хирургический метод выполнен 4 больным с последующей лучевой терапией. Лучевая терапия проведена на I этапе 3 пациентам, суммарная очаговая доза составила 66 Гр. Полихимиотерапия с последующей радиотерапией применялась в 3 случаях. Длительность наблюдения колебалась от 8 до 108 мес, медиана – 47,5 мес. Заключение. Эстезионейробластома является редкой злокачественной опухолью носа. Пик заболеваемости приходится на 50–70 лет. Гендерных различий не выявлено. Основными клиническими симптомами являются заложенность носа – 8 больных и различные нарушения обоняния – 7 пациентов. Основным методом визуализации на этапах диагностики, оценки эффекта и наблюдения является ПЭТ/КТ. При этом чаще всего (6 больных) определяется стадия С по Kadish.
Background. Esthesioneyroblastoma is a rare malignant tumor arising from olfactory neuroepithelium of the nasal cavity. It is an aggressive local tumor. It accounts for 3 to 6% of cases of nasal and sinus cancer. Occurs at any age. Due to the rarity of the disease, there are no uniform standards of treatment. A multimodal and interdisciplinary approach is recommended. Aim. To present the results of a retrospective study of patients with esthesioneuroblastoma.
Materials and methods. The retrospective study was carried out using the database of departments of radionuclide diagnostics of Nuclear Medicine Centres from 2012 to 2022. Ten patients with histologically confirmed diagnosis of esthesioneyroblastoma were identified. Results. Age of patients from 29 to 67 years, median – 51 years. Men and women – equal. The clinical picture was dominated by a sense of nasal congestion and various nose impairments – 8 and 7 patients. The tumor was more often confined to the left side of the nose. Computer tomography (CT), magnetic resonance imaging and positron emission tomography combined with CT (PET/CT) were used for diagnosis, estimation of tumor process prevalence and outpatient observation. Stage A by Kadish was identified in 2 cases, and stage B – in 1 patient. Stage C – 6 patients predominated. D was diagnosed in 1 patient. The use of PET/CT clarifies the primary stage, the effect of therapy, provides disease control during dynamic observation. The SUVmax median for primary tumor was 7.43 (4.3–19.1). A multi-modal approach is used to treat esthesioneuroblastoma. The surgical method is performed by 4 patients with subsequent radiation therapy. Radiation therapy was carried out at the first stage of 3 patients, the total focal dose was 66 Gy. Polychemotherapy followed by radiotherapy was used in 3 cases. Duration of observation ranged from 8 to 108 months, median – 47.5 months. Conclusion. Esthesioneyroblastoma is a rare malignant nasal tumor. The peak of the disease falls on 50–70 years. No gender differences have been identified. The main clinical symptoms are nasal congestion – 8 patients and various smelling disorders – 7 patients. PET/CT is the main imaging method in the diagnostic, evaluation and observation phases. In this case, most often (6 patients) is determined stage C by Kadish.
1. Broich G, Pagliari A, Ottaviani F. Esthesioneuroblastoma: a general review of the cases published since the discovery of the tumour in 1924. Anticancer Res. 1997;17:2683-706.
2. Limaiem F, M Das J. Esthesioneuroblastoma. In: StatPearls. Treasure Island (FL): StatPearls Publishing; 2022 Jan. Available at: https://www.ncbi.nlm.nih.gov/books/NBK539694/#_NBK539694_pubdet_. Accessed: 03.10.2022.
3. Schmidt C, Potter N, Porceddu S, Panizza B. Olfactory neuroblastoma: 14-year experience at an Australian tertiary centre and the role for longer-term surveillance. J Laryngol Otol. 2016;131(S2):S29-34. DOI:10.1017/s0022215116009592
4. Nalavenkata SB, Sacks R, Adappa ND, et al. Olfactory Neuroblastoma. Otolaryngol Head Neck Surg. 2015;154(2):383-9. DOI:10.1177/0194599815620173
5. Deng H, McDowell MM, Gersey ZC, et al. Esthesioneuroblastoma with recurrent dural metastases: Long-term multimodality treatment and considerations. Surg Neurol Int. 2021;12(606).
6. Jethanamest D, Morris LG, Sikora AG, Kutler DI. Esthesioneuroblastoma: a population-based analysis of survival and prognostic factors. Arch Otolaryngol Head Neck Surg. 2007;133:276-80.
7. Liermann J, Syed M, Held T, et al. Advanced Radiation Techniques in the Treatment of Esthesioneuroblastoma: A 7-Year Single-Institution's Clinical Experience. Cancers (Basel). 2018;10(11):457.
8. Tajudeen BA, Arshi A, Suh JD, et al. Importance of Tumor Grade in Esthesioneuroblastoma Survival: A Population-Based Analysis. JAMA Otolaryngol Head Neck Surg. 2014;140(12):1124-9. DOI:10.1001/jamaoto.2014.2541
9. Rimmer J, Lund VJ, Beale T, et al. Olfactory neuroblastoma: a 35-year experience and suggested follow-up protocol. Laryngoscope. 2014;124:1542-9.
10. Dias FL, Sa GM, Lima RA, et al. Patterns of failure and outcome in esthesioneuroblastoma. Arch Otolaryngol Head Neck Surg. 2003;129:1186-92.
11. Dulguerov P, Allal AS, Calcaterra TC. Esthesioneuroblastoma: a meta-analysis and review. Lancet Oncol. 2001;2:683-90.
12. Petruzzelli GJ, Howell JB, Pederson A, et al. Multidisciplinary treatment of olfactory neuroblastoma: patterns of failure and management of recurrence. Am J Otolaryngol. 2015;36:547-53.
13. McLean JN, Nunley SR, Klass C, et al. Combined modality therapy of esthesioneuroblastoma. Otolaryngol Head Neck Surg. 2007;136:998-1002.
14. Bachar G, Goldstein DP, Shah M, et al. Esthesioneuroblastoma: The Princess Margaret Hospital experience. Head Neck. 2008;30:1607-14. DOI:10.1002/hed.20920
15. Fujioka T, Toriihara A, Kubota K, et al. Long-term follow-up using 18F-FDG PET/CT for postoperative olfactory neuroblastoma. Nucl Med Commun. 2014;35(8):857-63. DOI:10.1097/mnm.0000000000000135
16. Kadish S, Goodman M, Wang CC. Olfactory neuroblastoma. A clinical analysis of 17 cases. Cancer. 1976;37:1571-6.
17. Morita A, Ebersold MJ, Olsen KD, et al. Esthesioneuroblastoma: prognosis and management. Neurosurgery. 1993;32:706-15.
18. Dulguerov P, Calcaterra T. Esthesioneuroblastoma: the UCLA experience 1970–1990. Laryngoscope. 1992;102:843-9.
19. Theilgaard SA, Buchwald C, Ingeholm P, et al. Esthesioneuroblastoma: A Danish demographic study of 40 patients registered between 1978 and 2000. Acta Otolaryngol. 2003;123:433-9.
20. Ow TJ, Bell D, Kupferman ME, et al. Esthesioneuroblastoma. Neurosurg Clin N Am. 2013;24(1):51-65.
21. Saade RE, Hanna EY, Bell D. Prognosis and biology in esthesioneuroblastoma: the emerging role of Hyams grading system. Curr Oncol Rep. 2015;17(1):423.
22. Kane AJ, Sughrue ME, Rutkowski MJ, et al. Posttreatment prognosis of patients with esthesioneuroblastoma. J Neurosurg. 2010;113:340-51.
23. Bak M, Wein RO. Esthesioneuroblastoma: a contemporary review of diagnosis and management. Hematol Oncol Clin North Am. 2012;26:1185-207.
24. Fu TS, Monteiro E, Muhanna N, et al. Comparison of outcomes for open versus endoscopic approaches for olfactory neuroblastoma: a systematic review and individual participant data meta-analysis. Head Neck. 2015;30:2306-16.
25. Sekhar LN, Heros RC. Origin, growth, and rupture of saccular aneurysms: A review. Neurosurgery. 1981;8:248-60.
26. Polin RS, Sheehan JP, Chenelle AG, et al. The role of preoperative adjuvant treatment in the management of esthesioneuroblastoma: the University of Virginia experience. Neurosurgery. 1998;42:1029-37.
27. Miller KC, Marinelli JP, Janus JR, et al. Induction Therapy Prior to Surgical Resection for Patients Presenting with Locally Advanced Esthesioneuroblastoma. J Neurol Surg B Skull Base. 2021;82(Suppl. 3):e131-7. DOI:10.1055/s-0039-3402026
28. Broski SM, Hunt CH, Johnson GB, et al. The Added Value of 18F-FDG PET/CT for Evaluation of Patients with Esthesioneuroblastoma. J Nucl Med. 2012;53(8):1200-6. DOI:10.2967/jnumed.112.102897
29. Arffa RE, Caballero N, Lanza DC, et al. Positive Correlation of Hyams Histopathologic Grading in Esthesioneuroblastoma to PET/CT Enhancement and Survival Rates. J Neurol Surg B Skull Base. 2016;77:A002. DOI:10.1055/s-0036-1579793
________________________________________________
1. Broich G, Pagliari A, Ottaviani F. Esthesioneuroblastoma: a general review of the cases published since the discovery of the tumour in 1924. Anticancer Res. 1997;17:2683-706.
2. Limaiem F, M Das J. Esthesioneuroblastoma. In: StatPearls. Treasure Island (FL): StatPearls Publishing; 2022 Jan. Available at: https://www.ncbi.nlm.nih.gov/books/NBK539694/#_NBK539694_pubdet_. Accessed: 03.10.2022.
3. Schmidt C, Potter N, Porceddu S, Panizza B. Olfactory neuroblastoma: 14-year experience at an Australian tertiary centre and the role for longer-term surveillance. J Laryngol Otol. 2016;131(S2):S29-34. DOI:10.1017/s0022215116009592
4. Nalavenkata SB, Sacks R, Adappa ND, et al. Olfactory Neuroblastoma. Otolaryngol Head Neck Surg. 2015;154(2):383-9. DOI:10.1177/0194599815620173
5. Deng H, McDowell MM, Gersey ZC, et al. Esthesioneuroblastoma with recurrent dural metastases: Long-term multimodality treatment and considerations. Surg Neurol Int. 2021;12(606).
6. Jethanamest D, Morris LG, Sikora AG, Kutler DI. Esthesioneuroblastoma: a population-based analysis of survival and prognostic factors. Arch Otolaryngol Head Neck Surg. 2007;133:276-80.
7. Liermann J, Syed M, Held T, et al. Advanced Radiation Techniques in the Treatment of Esthesioneuroblastoma: A 7-Year Single-Institution's Clinical Experience. Cancers (Basel). 2018;10(11):457.
8. Tajudeen BA, Arshi A, Suh JD, et al. Importance of Tumor Grade in Esthesioneuroblastoma Survival: A Population-Based Analysis. JAMA Otolaryngol Head Neck Surg. 2014;140(12):1124-9. DOI:10.1001/jamaoto.2014.2541
9. Rimmer J, Lund VJ, Beale T, et al. Olfactory neuroblastoma: a 35-year experience and suggested follow-up protocol. Laryngoscope. 2014;124:1542-9.
10. Dias FL, Sa GM, Lima RA, et al. Patterns of failure and outcome in esthesioneuroblastoma. Arch Otolaryngol Head Neck Surg. 2003;129:1186-92.
11. Dulguerov P, Allal AS, Calcaterra TC. Esthesioneuroblastoma: a meta-analysis and review. Lancet Oncol. 2001;2:683-90.
12. Petruzzelli GJ, Howell JB, Pederson A, et al. Multidisciplinary treatment of olfactory neuroblastoma: patterns of failure and management of recurrence. Am J Otolaryngol. 2015;36:547-53.
13. McLean JN, Nunley SR, Klass C, et al. Combined modality therapy of esthesioneuroblastoma. Otolaryngol Head Neck Surg. 2007;136:998-1002.
14. Bachar G, Goldstein DP, Shah M, et al. Esthesioneuroblastoma: The Princess Margaret Hospital experience. Head Neck. 2008;30:1607-14. DOI:10.1002/hed.20920
15. Fujioka T, Toriihara A, Kubota K, et al. Long-term follow-up using 18F-FDG PET/CT for postoperative olfactory neuroblastoma. Nucl Med Commun. 2014;35(8):857-63. DOI:10.1097/mnm.0000000000000135
16. Kadish S, Goodman M, Wang CC. Olfactory neuroblastoma. A clinical analysis of 17 cases. Cancer. 1976;37:1571-6.
17. Morita A, Ebersold MJ, Olsen KD, et al. Esthesioneuroblastoma: prognosis and management. Neurosurgery. 1993;32:706-15.
18. Dulguerov P, Calcaterra T. Esthesioneuroblastoma: the UCLA experience 1970–1990. Laryngoscope. 1992;102:843-9.
19. Theilgaard SA, Buchwald C, Ingeholm P, et al. Esthesioneuroblastoma: A Danish demographic study of 40 patients registered between 1978 and 2000. Acta Otolaryngol. 2003;123:433-9.
20. Ow TJ, Bell D, Kupferman ME, et al. Esthesioneuroblastoma. Neurosurg Clin N Am. 2013;24(1):51-65.
21. Saade RE, Hanna EY, Bell D. Prognosis and biology in esthesioneuroblastoma: the emerging role of Hyams grading system. Curr Oncol Rep. 2015;17(1):423.
22. Kane AJ, Sughrue ME, Rutkowski MJ, et al. Posttreatment prognosis of patients with esthesioneuroblastoma. J Neurosurg. 2010;113:340-51.
23. Bak M, Wein RO. Esthesioneuroblastoma: a contemporary review of diagnosis and management. Hematol Oncol Clin North Am. 2012;26:1185-207.
24. Fu TS, Monteiro E, Muhanna N, et al. Comparison of outcomes for open versus endoscopic approaches for olfactory neuroblastoma: a systematic review and individual participant data meta-analysis. Head Neck. 2015;30:2306-16.
25. Sekhar LN, Heros RC. Origin, growth, and rupture of saccular aneurysms: A review. Neurosurgery. 1981;8:248-60.
26. Polin RS, Sheehan JP, Chenelle AG, et al. The role of preoperative adjuvant treatment in the management of esthesioneuroblastoma: the University of Virginia experience. Neurosurgery. 1998;42:1029-37.
27. Miller KC, Marinelli JP, Janus JR, et al. Induction Therapy Prior to Surgical Resection for Patients Presenting with Locally Advanced Esthesioneuroblastoma. J Neurol Surg B Skull Base. 2021;82(Suppl. 3):e131-7. DOI:10.1055/s-0039-3402026
28. Broski SM, Hunt CH, Johnson GB, et al. The Added Value of 18F-FDG PET/CT for Evaluation of Patients with Esthesioneuroblastoma. J Nucl Med. 2012;53(8):1200-6. DOI:10.2967/jnumed.112.102897
29. Arffa RE, Caballero N, Lanza DC, et al. Positive Correlation of Hyams Histopathologic Grading in Esthesioneuroblastoma to PET/CT Enhancement and Survival Rates. J Neurol Surg B Skull Base. 2016;77:A002. DOI:10.1055/s-0036-1579793
1 ФГБОУ ВО «Тамбовский государственный университет им. Г.Р. Державина», Тамбов, Россия;
2 ООО «ПЭТ-Технолоджи», Тамбов, Россия;
3 ГБУЗ «Тамбовский областной онкологический клинический диспансер», Тамбов, Россия
*ognerubov_n.a@mail.ru
________________________________________________
Nikolai A. Ognerubov*1, Tatiana S. Antipova2, Marina A. Ognerubova3
1 Derzhavin Tambov State University, Tambov, Russia;
2 PET-Technology, Tambov, Russia;
3 Tambov Regional Oncological Clinical Dispensary, Tambov, Russia
*ognerubov_n.a@mail.ru