Esthesioneuroblastomas with intracranial extension: proliferative potential and management

Tatagiba, Marcos; Samii, Madjid; Dankoweit-Timpe, Eva; Aguiar, Paulo Henrique P.; Osterwald, Lutz; Babu, Ramesh; Ostertag, Helmut

doi:10.1590/S0004-282X1995000400005

Abstracts

A total of 15 patients with esthesioneuroblastomas were treated between 1978 and 1992 at the Neurosurgery Department, Nordstadt Hospital, Hannover. In 9 cases, the tumors invaded the anterior cranial fossa. One patient died before any surgical intervention. Eight tumors were operated by a combined paranasal and subfrontal approach. Gross total tumor removal was achieved in all cases. Apart from anosmia, the only postoperative complication was transient mental changes in one case. Immunohistochemical analyses with MIB 1 monoclonal antibodies, directed against recombinant parts of Ki-67 antigen, were performed to estimate the proliferative potential of the esthesioneuroblastomas. Most of the tumors showed high proliferating cell indexes, which ranged from 3 to 42% (mean, 16%). The proliferating cell index with MIB 1 showed a correlation with postoperative outcome, although this was not statistically significant. Esthesioneuroblastomas can be totally removed surgically. The proliferating cell index may reflect histologically the biological behavior of tumor. Long-term follow-up is mandatory, and imunohistochemical studies may be of help in predicting outcome.

anterior cranial base; MIB 1; neuroblastoma; olfactory nerve; paranasal sinuses; radiotherapy

O índice proliferative celular tumoral de 8 casos cirúrgicos de estesioneuroblastomas com extensão intracraniana (9 com extensão intracraniana em um total de 15, coletados de 1978 a 1992 no Hospital Nordstadt de Hannover, Alemanha) foi avaliado através do anticorpo monoclonal MIB-1, notando -se uma correlação prognostica. A maioria dos tumores revelou índice proliferative) alto (3% a 42%, média de 16%) e a classificação histopatológica de Hyam foi utilizada. A ressecção foi radical em 100% dos casos e o acesso cirúrgico combinado (paranasal e subfrontal) o preconizado. Os autores apresentam revisão da literatura discutindo a sua casuística.

base craniana anterior; MIB 1; neuroblastoma; nervo olfatório; seios paranasais; radioterapia

Esthesioneuroblastomas with intracranial extension. Proliferative potential and management

Estesioneuroblastomas com extensão intracraniana: análise do potencial proliferative e conduta

Marcos Tatagiba^I; Madjid Samii^I; Eva Dankoweit-Timpe^II; Paulo Henrique P. Aguiar^I; Lutz Osterwald^III; Ramesh Babu^I; Helmut Ostertag^II

^IDepartment of Neurosurgery; Nordstadt Hospital, Hannover, Germany

^IIInstitut of Pathology; Nordstadt Hospital, Hannover, Germany

^IIIDepartment of Ear, Nose and Throat (ENT). Nordstadt Hospital, Hannover, Germany

SUMMARY

A total of 15 patients with esthesioneuroblastomas were treated between 1978 and 1992 at the Neurosurgery Department, Nordstadt Hospital, Hannover. In 9 cases, the tumors invaded the anterior cranial fossa. One patient died before any surgical intervention. Eight tumors were operated by a combined paranasal and subfrontal approach. Gross total tumor removal was achieved in all cases. Apart from anosmia, the only postoperative complication was transient mental changes in one case. Immunohistochemical analyses with MIB 1 monoclonal antibodies, directed against recombinant parts of Ki-67 antigen, were performed to estimate the proliferative potential of the esthesioneuroblastomas. Most of the tumors showed high proliferating cell indexes, which ranged from 3 to 42% (mean, 16%). The proliferating cell index with MIB 1 showed a correlation with postoperative outcome, although this was not statistically significant. Esthesioneuroblastomas can be totally removed surgically. The proliferating cell index may reflect histologically the biological behavior of tumor. Long-term follow-up is mandatory, and imunohistochemical studies may be of help in predicting outcome.

Key words:anterior cranial base, MIB 1, neuroblastoma, olfactory nerve, paranasal sinuses, radiotherapy.

RESUMO

O índice proliferative celular tumoral de 8 casos cirúrgicos de estesioneuroblastomas com extensão intracraniana (9 com extensão intracraniana em um total de 15, coletados de 1978 a 1992 no Hospital Nordstadt de Hannover, Alemanha) foi avaliado através do anticorpo monoclonal MIB-1, notando -se uma correlação prognostica. A maioria dos tumores revelou índice proliferative) alto (3% a 42%, média de 16%) e a classificação histopatológica de Hyam foi utilizada. A ressecção foi radical em 100% dos casos e o acesso cirúrgico combinado (paranasal e subfrontal) o preconizado. Os autores apresentam revisão da literatura discutindo a sua casuística.

Palavras-chave:base craniana anterior, MIB 1 .neuroblastoma, nervo olfatório, seios paranasais, radioterapia.

Texto completo disponível apenas em PDF.

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Aceite: 8-maio-1995.

Marcos Tatagiba, MD - Neurochirurgische Klinik, Krankenhaus Nordstadt - Haltenhoffstr. 41 - 30167 Hannover, Germany. Fax 49-511-7638606 II Dr.Paulo Henrique P. Aguiar - Rua Raul Pompéia 1050 apto 111 - 05025-010 São Paulo SP - Brasil.

1. Berger L, Luc R. L'esthesioneuroepitheliome olfactif. Bull Assoc Franc Etude Cancer 1924, 13:410-421.
2. Biller HF, Lawson W, Sachdev VP, Som P. Esthesioneuroblastoma: surgical treatment without radiation. Laryngoscope 1990, 100:1199-1201.
3. Burke DP, Gabrielsen TO, Knake JE, Surger JF, Oberman HA. Radiology of olfactory neuroblastoma. Radiology 1980, 137:367-372.
4. Cantrell RW. Esthesioneuroblastoma. In Sekhar LN, Janecka IP (eds). Surgery of cranial base tumors. New York: Raven Press, 1993, p 471-476.
5. Canty P. Olfactory neuroblastoma: long-term survival. J Laryngol Otol 1979, 93:285.
6. Cattoretti G, Becker MHG, Key G, Duchrow M, Schlueter C, Galle J, Gerdes J. Monoclonal antibodies against recombinant parts of the Ki-67 antigen (MIB 1 and MIB 3) detect proliferating cells in microwave processed formalin-fixed paraffin sections. J Pathol 1992, 168:357-363.
7. Cheesman A, Lund VJ, Howard DJ. Craniofacial resection for tumors of the nasal cavity and paranasal sinuses. Head Neck Surg 1986, 8:429-435.
8. Cummings LW. Otolaryngology head and neck surgery. St. Louis: Mosby, 1986, p 3397-3398.
9. Doyle P, Payton H. Combined surgical approach to esthesioneuroepithelioma. Trans Pa Acad Ophthalmol Otolaryngol 1971,75:526-531.
10. Durham JC. Olfactory neuroblastoma. Ear Nose Throat J 1989, 68:185-204.
11. Fahlbush R, Neubauer U, Wigand M, Weidenbecher M, Röckelein G, Thierauf P, Sauer R. Neuro-rhinosurgical treatment of aesthesioneuroblastoma. Acta Neurochir (Wien) 1989, 100:93-100.
12. Garces LAR-N, Heiss E, Grote E. Sudden blindness by an esthesioneuroblastoma: case report. In Sheunemann H, Schürmann K, Helms J (eds). Tumors of the skull base: extra- and intracranial surgery of skull base tumors. Berlin: Walter de Gruyter, 1986, p 127-130.
13. Goldsweig HG, Sundaresan N. Chemotherapy of recurrent esthesioneuroblastoma: case report and review of literature. Am J Clin Oncol 1990, 13:139-143.
14. Hamilton AE, Rubinstein LJ, Poole GJ. Primary intracranial esthesioneuroblastoma. J Neurosurg 1973, 39:548-556.
15. Harrison D. Surgical pathology of olfactory neuroblastoma. Head Neck Surg 1984, 7:60-64.
16. Hyams VJ, Batsakis JG, Michaels L. Tumors of the upper respiratory tract and ear, In Hyams VJ, Batsakis JG, Michaels L (eds). Atlas of tumor pathology, Second Series, Fascicle 25. Washington, DC: Armed Forces Institute of Pathology, 1988, p 240-248.
17. Hurst RW, Erickson S, Cail WS, Newman SA, Levine PA, Burke J, Cantrell RW. Computed tomographic features of esthesioneuroblastoma. Neuroradiology 1989, 31:253-257.
18. Kadish S, Goodmann M, Wang CC. Olfactory neuroblastoma. Cancer 1976, 37:1571-1576.
19. Mack EE, Prados MD, Wilson CB. Late manifestation of esthesioneuroblastomas in the central nervous system: report of two cases. Neurosurgery 1992,30:93-97.
20. Meneses MS, Thurel C, Mikol J, Ramina R, Maniglia JJ, Arruda WO, Cophignon J. Esthesioneuroblastoma with intracranial extension. Neurosurgery 1990, 27:813-820.
21. Mills SE, Frierson HF. Olfactory neuroblastoma: a clinicopathologic study of 21 cases. Am J Surg Pathol 1985, 9:317-327.
22. Morita A, Ebersold MJ, Olsen KD, Foote RL, Lewis JE, Quast LM. Esthesioneuroblastoma: prognosis and management. Neurosurgery 1993, 32: 706-715.
23. Newbill ET, Johns ME, Cantrell RW. Esthesioneuroblastomas: diagnosis and treatment. South Med J 1985, 78:275-282.
24. O'Connor TA, McLean P, Juillard GJF. Olfactory neuroblastomas. Cancer 1989, 63:2426-2428.
25. Olsen KD, De Santo LW. Olfactory neuroblastoma: biologic and clinical behaviour. Arch Otolaryng 1983,109:797-802.
26. Rodas RA, Erkman-Balis B, Cahill DW. Late intracranial metastasis from esthesioneuroblastoma: case report and review of the literature. Neurosurgery 1986, 19:622-627.
27. Russell DS, Rubinstein LJ. Pathology of tumours of the nervous system. Ed 5. London: Williams & Wilkins, 1989, p 915-920.
28. Samii M, Löblich HJ, Draf W. Esthesioneuroblastoma. In Sheunemann H, Schürmann K, Helms J (eds). Tumors of the skull base: extra- and intracranial surgery of skull base tumors. Berlin: Walter de Gruyter, 1986, p 53-57.
29. Schall LA, Linback M. Primary intranasal neuroblastoma. Ann Otol Rhinol Laryngol 1951, 60:221-229.
30. Schroth G, Gawehn J, Marquardt B, Schabet M. MR imaging of esthesioneuroblastoma: case report. JComput Assist Tomogr 1986, 10:316-319.
31. Schwaab G, Micheau C, Le Guillou C, Marandas P, Pacheco L, Domenge C, Richard JM, Wibault P. Olfactory esthesioneuroma: a report of 40 cases. Laryngoscope 1988, 98:872-876.
32. Skolnik EM, Massari FS, Tenta LT. Olfactory neuroepithelioma: review of world literature and presentation of two cases. Arch Otolaryngol 1966, 84:644-653.
33. Taxy JB, Bharani NK, Mills SE, Frierson HF, Gould VE. The spectrum of olfactory neural tumors: a light microscopic immunohistochemical and ultrastructural analysis. Am J Surg Pathol 1986, 10:687-695.
34. Watne K, Hager B. Treatment of recurrent esthesioneuroblastoma with combined intracranial chemotherapy: a case report. J Neurooncol 197, 5:47-50.
35. Weiden PL, Yarington T, Richardson RG. Olfactory neuroblastoma: chemotherapy and radiotherapy for extensive disease. Arch Otoryngol 1984, 110:759-760.
36. Wilson WMG, Cullen G. Olfactory groove tumor causing sudden blindness: a case report. Can J Ophthalmol 1967, 2:133-138.
37. Zülch KJ. Brain tumors: their biology and pathology. Berlin: Springer, 1986, p 483-485.

Publication Dates

Publication in this collection
20 Dec 2010
Date of issue
Sept 1995

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

[1] 1. Berger L, Luc R. L'esthesioneuroepitheliome olfactif. Bull Assoc Franc Etude Cancer 1924, 13:410-421.

[2] 2. Biller HF, Lawson W, Sachdev VP, Som P. Esthesioneuroblastoma: surgical treatment without radiation. Laryngoscope 1990, 100:1199-1201.

[3] 3. Burke DP, Gabrielsen TO, Knake JE, Surger JF, Oberman HA. Radiology of olfactory neuroblastoma. Radiology 1980, 137:367-372.

[4] 4. Cantrell RW. Esthesioneuroblastoma. In Sekhar LN, Janecka IP (eds). Surgery of cranial base tumors. New York: Raven Press, 1993, p 471-476.

[5] 5. Canty P. Olfactory neuroblastoma: long-term survival. J Laryngol Otol 1979, 93:285.

[6] 6. Cattoretti G, Becker MHG, Key G, Duchrow M, Schlueter C, Galle J, Gerdes J. Monoclonal antibodies against recombinant parts of the Ki-67 antigen (MIB 1 and MIB 3) detect proliferating cells in microwave processed formalin-fixed paraffin sections. J Pathol 1992, 168:357-363.

[7] 7. Cheesman A, Lund VJ, Howard DJ. Craniofacial resection for tumors of the nasal cavity and paranasal sinuses. Head Neck Surg 1986, 8:429-435.

[8] 8. Cummings LW. Otolaryngology head and neck surgery. St. Louis: Mosby, 1986, p 3397-3398.

[9] 9. Doyle P, Payton H. Combined surgical approach to esthesioneuroepithelioma. Trans Pa Acad Ophthalmol Otolaryngol 1971,75:526-531.

[10] 10. Durham JC. Olfactory neuroblastoma. Ear Nose Throat J 1989, 68:185-204.

[11] 11. Fahlbush R, Neubauer U, Wigand M, Weidenbecher M, Röckelein G, Thierauf P, Sauer R. Neuro-rhinosurgical treatment of aesthesioneuroblastoma. Acta Neurochir (Wien) 1989, 100:93-100.

[12] 12. Garces LAR-N, Heiss E, Grote E. Sudden blindness by an esthesioneuroblastoma: case report. In Sheunemann H, Schürmann K, Helms J (eds). Tumors of the skull base: extra- and intracranial surgery of skull base tumors. Berlin: Walter de Gruyter, 1986, p 127-130.

[13] 13. Goldsweig HG, Sundaresan N. Chemotherapy of recurrent esthesioneuroblastoma: case report and review of literature. Am J Clin Oncol 1990, 13:139-143.

[14] 14. Hamilton AE, Rubinstein LJ, Poole GJ. Primary intracranial esthesioneuroblastoma. J Neurosurg 1973, 39:548-556.

[15] 15. Harrison D. Surgical pathology of olfactory neuroblastoma. Head Neck Surg 1984, 7:60-64.

[16] 16. Hyams VJ, Batsakis JG, Michaels L. Tumors of the upper respiratory tract and ear, In Hyams VJ, Batsakis JG, Michaels L (eds). Atlas of tumor pathology, Second Series, Fascicle 25. Washington, DC: Armed Forces Institute of Pathology, 1988, p 240-248.

[17] 17. Hurst RW, Erickson S, Cail WS, Newman SA, Levine PA, Burke J, Cantrell RW. Computed tomographic features of esthesioneuroblastoma. Neuroradiology 1989, 31:253-257.

[18] 18. Kadish S, Goodmann M, Wang CC. Olfactory neuroblastoma. Cancer 1976, 37:1571-1576.

[19] 19. Mack EE, Prados MD, Wilson CB. Late manifestation of esthesioneuroblastomas in the central nervous system: report of two cases. Neurosurgery 1992,30:93-97.

[20] 20. Meneses MS, Thurel C, Mikol J, Ramina R, Maniglia JJ, Arruda WO, Cophignon J. Esthesioneuroblastoma with intracranial extension. Neurosurgery 1990, 27:813-820.

[21] 21. Mills SE, Frierson HF. Olfactory neuroblastoma: a clinicopathologic study of 21 cases. Am J Surg Pathol 1985, 9:317-327.

[22] 22. Morita A, Ebersold MJ, Olsen KD, Foote RL, Lewis JE, Quast LM. Esthesioneuroblastoma: prognosis and management. Neurosurgery 1993, 32: 706-715.

[23] 23. Newbill ET, Johns ME, Cantrell RW. Esthesioneuroblastomas: diagnosis and treatment. South Med J 1985, 78:275-282.

[24] 24. O'Connor TA, McLean P, Juillard GJF. Olfactory neuroblastomas. Cancer 1989, 63:2426-2428.

[25] 25. Olsen KD, De Santo LW. Olfactory neuroblastoma: biologic and clinical behaviour. Arch Otolaryng 1983,109:797-802.

[26] 26. Rodas RA, Erkman-Balis B, Cahill DW. Late intracranial metastasis from esthesioneuroblastoma: case report and review of the literature. Neurosurgery 1986, 19:622-627.

[27] 27. Russell DS, Rubinstein LJ. Pathology of tumours of the nervous system. Ed 5. London: Williams & Wilkins, 1989, p 915-920.

[28] 28. Samii M, Löblich HJ, Draf W. Esthesioneuroblastoma. In Sheunemann H, Schürmann K, Helms J (eds). Tumors of the skull base: extra- and intracranial surgery of skull base tumors. Berlin: Walter de Gruyter, 1986, p 53-57.

[29] 29. Schall LA, Linback M. Primary intranasal neuroblastoma. Ann Otol Rhinol Laryngol 1951, 60:221-229.

[30] 30. Schroth G, Gawehn J, Marquardt B, Schabet M. MR imaging of esthesioneuroblastoma: case report. JComput Assist Tomogr 1986, 10:316-319.

[31] 31. Schwaab G, Micheau C, Le Guillou C, Marandas P, Pacheco L, Domenge C, Richard JM, Wibault P. Olfactory esthesioneuroma: a report of 40 cases. Laryngoscope 1988, 98:872-876.

[32] 32. Skolnik EM, Massari FS, Tenta LT. Olfactory neuroepithelioma: review of world literature and presentation of two cases. Arch Otolaryngol 1966, 84:644-653.

[33] 33. Taxy JB, Bharani NK, Mills SE, Frierson HF, Gould VE. The spectrum of olfactory neural tumors: a light microscopic immunohistochemical and ultrastructural analysis. Am J Surg Pathol 1986, 10:687-695.

[34] 34. Watne K, Hager B. Treatment of recurrent esthesioneuroblastoma with combined intracranial chemotherapy: a case report. J Neurooncol 197, 5:47-50.

[35] 35. Weiden PL, Yarington T, Richardson RG. Olfactory neuroblastoma: chemotherapy and radiotherapy for extensive disease. Arch Otoryngol 1984, 110:759-760.

[36] 36. Wilson WMG, Cullen G. Olfactory groove tumor causing sudden blindness: a case report. Can J Ophthalmol 1967, 2:133-138.

[37] 37. Zülch KJ. Brain tumors: their biology and pathology. Berlin: Springer, 1986, p 483-485.