RESUMO
CASE DESCRIPTION: A 4-year-old sexually intact male leucistic axolotl (Ambystoma mexicanum) was presented with a 2-week history of dysrexia and difficulty swallowing. CLINICAL FINDINGS: Physical examination revealed a 1-cm-diameter intraoral mass on the rostral aspect of the palate and swelling of the left nasal fossa. Local invasion into the left nasal fossa was suspected during oral examination. The lesion was marginally excised, and an incompletely excised olfactory neuroblastoma was diagnosed histologically. Five weeks later, physical examination revealed persistent erythema, delayed healing of the rostral portion of the palate, and a mild facial deformity associated with a white mass in the nasal cavity. TREATMENT AND OUTCOME: 6 weeks after excision, adjuvant electron (6-MeV) beam radiotherapy was initiated for treatment of the incompletely excised olfactory neuroblastoma and likely presence of a recurrent mass. The protocol consisted of 4 weekly fractions of 8 Gy each (total, 32 Gy) with the axolotl under anesthesia. No acute adverse radiation effects were noted following radiotherapy. The oral erythema resolved after the third session. No recurrence was observed 2 months after treatment, and the owners reported no abnormal signs at home. The axolotl died 3.5 months after radiotherapy was completed (8 months after marginal excision of the tumor) secondary to an environmental management failure. Postmortem histologic evaluation showed no evidence of neoplasia. CLINICAL RELEVANCE: In axolotls, olfactory neuroblastoma should be considered in the differential diagnosis of intraoral palatal masses. This report describes the first application of radiotherapy for treatment of an olfactory neuroblastoma in an axolotl.
Assuntos
Estesioneuroblastoma Olfatório , Neoplasias Nasais , Ambystoma mexicanum , Animais , Biópsia/veterinária , Estesioneuroblastoma Olfatório/diagnóstico , Estesioneuroblastoma Olfatório/radioterapia , Estesioneuroblastoma Olfatório/cirurgia , Estesioneuroblastoma Olfatório/veterinária , Masculino , Cavidade Nasal/patologia , Neoplasias Nasais/diagnóstico , Neoplasias Nasais/radioterapia , Neoplasias Nasais/cirurgia , Neoplasias Nasais/veterináriaRESUMO
Estesioneuroblastoma o también llamado neuroblastoma olfatorio es un tumor maligno infrecuente derivado del neuroepitelio olfatorio. La historia clínica de un paciente con un neuroblastoma olfatorio es muy inespecífica. Durante la última década, los métodos endoscópicos se han aplicado gradualmente para el tratamiento de tumores de la base del cráneo. El tratamiento puramente endoscópico endonasal del estesioneuroblastoma ha mostrado excelentes resultados de supervivencia con disminución de las complicaciones. Presentamos un paciente afectado por un neuroblastoma olfatorio tratado solo con cirugía endoscópica endonasal.
Esthesioneuroblastoma or olfactory neuroblastoma is an uncommon malignant tumor arising from the olfactory neuroepithelium. The clinical symptoms of a patient with olfactory neuroblastoma are very inespecific. During the past decade, endoscopic approaches have been gradually applied in treating skull base tumors. The purely endoscopic endonasal surgery for esthesioneuroblastoma showed successful survival results with remarkably decreased complications. We reported a patient who suffered olfactory neuroblastoma treated with only endoscopic endonasal surgery.
Assuntos
Humanos , Masculino , Adulto , Endoscopia/métodos , Estesioneuroblastoma Olfatório/diagnóstico , Estesioneuroblastoma Olfatório/cirurgia , Neoplasias Nasais/diagnóstico , Neoplasias Nasais/cirurgia , Base do CrânioRESUMO
O estesioneuroblastoma (ENB) é uma neoplasia rara que atinge o neuroepitélio olfativo, comumente invadindo os seios paranasais, a base do crânio e a região orbitária. Apresenta metástase em 10 a 30 % dos casos. Distribui-se de forma bimodal para a idade, principalmente dos 11 aos 20 anos e dos 51 aos 60 anos, sem influência do sexo e raça do indivíduo. A ínfima quantidade de casos relatados resulta em dúvidas quanto ao melhor tratamento a ser dispensado ao paciente. Relatamos três casos, todos Kadish C, tornando o tratamento e o prognóstico um desafio à prática neurocirúrgica.
The esthesioneuroblastoma (ENB) is a rare neoplasm that affects the olfactory neuroepithelium, commonly invading the paranasal sinuses, skull base and the orbital region. Shows metastasis in 10% to 30% of cases. Distributed in a bimodal shape for the age, from 11 to 20 years and 51 to 60 years especially, with no influence of gender and race of the individual. The tiny amount of reported cases result in doubt about the best treatment to be dispensed to the patient. We report three cases, all Kadish C, making treatment and prognosis a challenge to neurosurgery.
Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Estesioneuroblastoma Olfatório/cirurgia , Estesioneuroblastoma Olfatório/diagnóstico , Estesioneuroblastoma Olfatório/radioterapia , Neoplasias da Base do CrânioRESUMO
O neuroblastoma olfatório, também conhecido como estesioneuroblastoma (ENB), é tumor maligno de crescimento lento, com origem principalmente na neuroectoderme da cavidade nasal. O pico de incidência do ENB é aos 53 anos, com a maioria dos casos ocorrendo entre os 40 e 70 anos, principalmente em homens. Há poucos relatos de ENB nos seios etmoidal, maxilar e esfenoidal, hipófise e nasofaringe. Esse tumor geralmenteapresenta-se como doença invasiva e tendência a recorrer tardiamente. A disseminação mais frequente do ENB é para os linfonodos cervicais e, se presente, significa pior prognóstico. Seus sintomas são inespecíficos, sendo a obstrução nasal o mais comum. Os exames de imagem são importantes no diagnóstico do ENB, juntamente com o histopatológico e o imuno-histoquímico, que também auxiliam no diagnóstico diferencial. O tratamento cirúrgico de ressecção craniofacial associado à radioterapia apresenta os melhores resultados na sobrevida. Descreve-se seguidamente um caso clínico ilustrativo dessa doença em paciente masculino de oito meses, faixa etária incomum da ENB, com queixa familiar inicial de obstrução nasal e coriza hialina com rajas de sangue...
Olfactory neuroblastoma, also known as esthesioneuroblastoma (ENB), is a slow-growing malignant tumor of that originates mainly in the neuroectodermal cells in the nasal cavity. The peak incidence of ENB is at age 53, with the majority of cases occurring between 40 and 70 years, and mostly among men. There are a few reports of ENB in the ethmoid, maxillary, and sphenoid sinuses, or in the pituitary and nasopharynx. This tumor usually presents as an invasive disease with a tendency for later recurrence. The most frequent dissemination of ENB is to the cervical lymph nodes, which represents a worse prognosis. Its symptoms are nonspecific and nasal obstruction is the most common complaint. Imaging tests are important for the diagnosis of ENB, along with histopathological and immunohistochemical tests to help in the differential diagnosis. Surgical treatment of craniofacial resection associated with radiotherapycan achieve the best results for survival. We present a discussion of an illustrative clinical case of the disease in a male patient aged eight months, an unusual age for ENB, brought to attention by an initial family complaint of nasal obstruction and bloodstained hyaline rhinorrhea...
Assuntos
Humanos , Masculino , Lactente , Estesioneuroblastoma Olfatório/diagnóstico , Estesioneuroblastoma Olfatório/epidemiologiaRESUMO
We report on a patient who presented to our clinic with a one-year history of diplopia in the left eye, epistaxis for one month and pain in the occipital area of the head. A biopsy of the area was performed and the lesion was diagnosed as Esthesioneuroblastoma also known olfactory neuroblastoma. Due to the size of the tumor and involvement of the vital intracranial structures it was decided to prescribe a palliative care program and palliative radiotherapy...
Se presenta el caso de una paciente que acudió a nuestra consulta con historia de un año de diplopía en el ojo izquierdo, epistaxis durante un mes y dolor en la zona occipital de la cabeza. Se realizó una biopsia del área y la lesión fue diagnosticada como estesioneuroblastoma también conocido neuroblastoma olfatorio. Debido al tamaño del tumor y la participación de las estructuras vitales intracraneales, se decidió prescribir un programa de cuidados paliativos y radioterapia paliativa...