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CC BY-NC-ND 4.0 · South Asian J Cancer 2022; 11(04): 336-339
DOI: 10.1055/s-0041-1739181
Original Article
Head and Neck Cancer

Experiences and Outcomes in Olfactory Neuroblastoma Over A Decade at a Tertiary Cancer Center

Himabindu Korra 
1   Department of Radiotherapy, MNJ Institute of Oncology & Regional Cancer Centre, Osmania Medical College, Hyderabad, Telangana, India
,
Joseph Benjamin Gandi
1   Department of Radiotherapy, MNJ Institute of Oncology & Regional Cancer Centre, Osmania Medical College, Hyderabad, Telangana, India
,
Prathyusha Nanuvala
1   Department of Radiotherapy, MNJ Institute of Oncology & Regional Cancer Centre, Osmania Medical College, Hyderabad, Telangana, India
,
Aarathi Ardha
1   Department of Radiotherapy, MNJ Institute of Oncology & Regional Cancer Centre, Osmania Medical College, Hyderabad, Telangana, India
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Abstract

Background Olfactory neuroblastoma is a rare epithelial malignancy arising from the odorant receptors in the nasal mucosa or along the cribriform plate of the ethmoid bone. Clinical presentation includes nasal stuffiness, local pain, epistaxis, anosmia, visual impairment, proptosis, headache, and seizures. Radiologic imaging with CT or MRI, an ophthalmic evaluation, and histopathologic confirmation with immunohistochemistry are parts of the initial diagnostic workup. Although surgery, chemotherapy, and radiation have an equally important role in the management, earlier stages may preferably be treated with surgery or radiotherapy and the later stages with a multimodality approach.

Materials and Methods We conducted a retrospective review of 13 patients diagnosed with olfactory neuroblastoma, registered at Mehdi Nawaz Jung Regional Cancer Center over a decade (2010–2019). We analyzed the age and sex distribution, performance status at presentation, clinical symptomatology, and the Kadish stage. In addition, the therapeutic aspects of patients were studied.

Results The most common presentation noted was nasal stuffiness, followed by epistaxis and proptosis. The majority of patients had good performance status at presentation. Ten patients presented with a Kadish stage C, while the remaining patients presented with Kadish stage B. Cervical nodal metastasis was seen in three patients, four patients received multimodality treatment with neoadjuvant chemoradiotherapy followed by surgery, two patients received neoadjuvant chemotherapy followed by radiation, two patients received only surgery, and one patient received surgery followed by adjuvant radiation. Conformal radiation techniques were used to deliver doses as high as 50 to 66 Gy in 2 Gy per fraction. Two patients presented with distant metastasis during follow-up, one with bone metastasis, and the other with retroperitoneal nodal metastasis; they received palliative chemotherapy and conformal radiation to the primary site.

Conclusion This study concludes that neoadjuvant chemotherapy followed by radiation gives the best outcomes. It has been observed that in multi-modality treatment, radiotherapy played a significant role in improving overall survival and better outcomes. Multidisciplinary discussions provide a better sequencing of management.

Keywords

Olfactory neuroblastoma - Kadish staging - Paranasal sinuses - Cribriform plate - Odorant receptors - Nasal cavity - Intensity-modulated radiation therapy


Publication History

Article published online:
16 August 2022

© 2022. MedIntel Services Pvt Ltd. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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