T10 Vertebraya Metastaz Yapmış Estezyonöroblastom: Vaka Sunumu Ve Literatür Taraması

Estezyonöroblastom olfaktuar epitelden köken alan nadir görülen malign bir tümördür. 52yaşındaki erkek hasta kliniğimize 3 aydır devam eden ilerleyici burun tıkanıklığı, burunkanaması ve nazal radikste kitle ile başvurdu. Rinoskopik muayenede her iki nazal kavitedepolipoid kitle görüldü ve lokal anestezi ile biyopsi yapıldı. Histopatolojik analiz sonucundaestezyonöroblastom tanısı konuldu. Tümör Kadish evre B olarak değerlendirildi. Endoskopikendonazal ve lateral rinotomi ile yaklaşımları ile kitle eksizyonu yapıldı. Postoperatif radyoterapiuygulandı. Takiplerinde cerrahiden 10 ay sonra submandibuler lenf nodu metastazı saptandı vehastaya bilateral tip 3 modifiye radikal boyun diseksiyonu yapıldı ve sonrasında radyoterapiuygulandı. Cerrahiden 12 ay sonra ise T10 vertebrada uzak metastaz saptandı. Hastanın uzakmetastazı olduğu halde primer bölgede rekürrens saptanmadı. Sonuç olarakestezyonöroblastomalarda lokal nüksler sık olduğu için hastaların dikkatli bir şekilde takipedilmeleri gereklidir ve aynı zamanda lokal rekürrens olmadan da uzak metastaz olabileceği deakılda tutulmalıdır

Anahtar Kelimeler:

Estezyonöroblastom, endonazal rezeksiyon, uzak metastaz, lokal rekürrens

Esthesioneuroblastoma with Unusual Metastasis to T10 Vertebra: Case Report and Review of the Literature

Esthesioneuroblastoma is a rare malignant tumor orginating from the olfactory epithelium. A52–year-old man admitted to our clinic with a 3 months history of progressive nasal obstruction,epistaxis and mass on the nasal radix. On rhinoscopy, a polypoid mass was seen in the bothnasal cavity and we performed an intranasal biopsy with local anesthesia. On histopathologicanalysis the tumor was identifed as an esthesioneuroblastoma. The tumor was classified asKadish stage B. The mass was excised via bilateral endoscopic endonasal resection and lateralrhinotomy approach. Radiotherapy was performed postoperatively. During the follow up,submandibuler lymph node metastasis occured ten months after surgery. The patient underwentbilateral type III modified radical neck dissection followed by radiotherapy to the neck. Distantmetastasis developed on the T 10 vertebra 12 months after the initial treatment. Although hehad distant metastasis he was free of local recurrence 13 th month after surgery. In conclusionbecause of locoregional recurrences are common in esthesioneuroblastomas, patients must befollowed carefully but also we have to remember that distant metastasis may appear withoutlocal recurrence

Keywords:

Esthesioneuroblastoma, endonasal resection, distant metastasis, local recurrence,

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