Rare case of mortality after hemorrhagic property of esthesioneuroblastoma.

IF 0.8 Q3 MEDICINE, GENERAL & INTERNAL
Archive of clinical cases Pub Date : 2023-12-14 eCollection Date: 2023-01-01 DOI:10.22551/2023.41.1004.10269
Todd Furr, Brandon Grodman, Jeremy Heffernan
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Abstract

Esthesioneuroblastoma is a tumor arising from olfactory neuroepithelium with an incidence of four per million. This case presents a rare nasal cavity neoplasm with hemorrhagic properties that may lead to significant sequelae. We present a 69-year-old male patient who presented with worsening altered mental status over the past 6-7 months. His Glasgow coma scale was a nine, showing a large mass centered at the cribriform plate with extension intracranially, sinonasal cavity, and bilateral orbits on diagnostics. Bifrontal craniotomy was performed one day after admission with resection of the tumor in the cranial fossa and intranasally, and decompression of the brainstem, frontal lobes, and third ventricle. After surgery, the patient was managed in the intensive care unit but continued to deteriorate. He was confirmed to have no meaningful brain activity and eventually deceased seven days after admission. Depending on the tumor stage, esthesioneuroblastoma can have a favorable prognosis with proper therapies. Different surgical techniques for ENB lead to the question of which therapeutic modality is the best because of the tumor's gross hemorrhagic properties. With adjunctive radiation therapy and/or chemotherapy, more research can bring light to proper surgical techniques.

雌性神经母细胞瘤出血后死亡的罕见病例。
嗅神经母细胞瘤(Esthesioneuroblastoma)是一种发生于嗅神经上皮的肿瘤,发病率为百万分之四。本病例是一种罕见的鼻腔肿瘤,具有出血特性,可能导致严重的后遗症。我们接诊了一名 69 岁的男性患者,他在过去 6-7 个月里出现了精神状态恶化。他的格拉斯哥昏迷量表为 9 分,诊断结果显示以楔形骨板为中心的巨大肿块向颅内、鼻窦腔和双侧眼眶扩展。入院一天后,患者接受了双额叶开颅手术,切除了颅窝和鼻腔内的肿瘤,并对脑干、额叶和第三脑室进行了减压。术后,患者在重症监护室接受治疗,但病情继续恶化。经证实,他的脑部活动已无意义,最终在入院七天后死亡。根据肿瘤的分期,动眼神经母细胞瘤通过适当的治疗可以获得良好的预后。由于ENB具有大量出血的特性,不同的手术技术导致了哪种治疗方式最好的问题。通过辅助放疗和/或化疗,更多的研究可以为正确的手术技术带来曙光。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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