Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0027627 (metastases)
 103,950 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Esthesioneuroblastoma is an uncommon tumor arising from the olfactory epithelium of the nasal cavity. Since most cases present clinically with non-specific findings such as unilateral nasal obstruction and intermittent epistaxis, esthesioneuroblastoma is often mistaken for other diseases of the nasal cavity. Histological confirmation of the disease can also be difficult. The aggressive nature of esthesioneuroblastoma is evidenced by frequent local recurrences and occasional distant metastases--further complicating the management of this tumor. The otolaryngologist should possess a high index of suspicion for this rare, but devastating malignancy. Guidelines for the evaluation and treatment are presented.
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PMID:Esthesioneuroblastoma: problems with diagnosis and management. 269 27

Fifteen patients with olfactory neuroblastoma were treated during the 17-year period of 1969 to 1986. Data was analyzed with respect to age at presentation, sex, presenting signs and symptoms, stage, and results of treatment. Age ranged from 4 to 67 years with the median age being 27 years. Median follow-up was 8 years. Local control was achieved in nine of nine patients or 100% with successful surgical resection, i.e., minimal residual disease, followed by postoperative radiation therapy (45 to 65 Gy) was employed. There were no distant failures when the primary site was controlled. Regional lymph node metastases were infrequent: only 13% (two of 15 patients) presented with positive nodes. Three of four patients treated initially with surgery alone had a local recurrence, two of which were successfully salvaged by combined therapy. There were four patients treated with radiation therapy alone: three had persistent disease after radiation therapy, and one patient was controlled with 65 Gy. Olfactory neuroblastoma has a propensity to recur locally when treated with surgery alone. The authors' experience suggests excellent local control can be achieved with surgery immediately followed by radiation therapy. Thus the authors recommend planned combined treatment for all resectable lesions.
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PMID:Olfactory neuroblastoma. 272 May 89

The olfactory neuroblastoma or esthesioneuroblastoma is a rare neuroectodermal tumor originating from the olfactory neuroepithelium, which can metastasis via cerebrospinal fluid pathways. In the present case of an extensive nasal malignancy with cervical lymph node metastases in a 75-year old woman, its difficult histology alternatively led to a diagnosis of anaplastic carcinoma and non-Hodgkin lymphoma. The patient died from complications following spread of the tumor to the spinal cord and cauda equina. Review of the literature shows that this tumor is notorious for its chameleonic character. In view of its clearly demonstrated malignancy an aggressive therapeutic approach is advocated.
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PMID:Olfactory neuroblastoma with spinal metastasis--a problem in diagnosis. 302 77

Olfactory esthesioneuroma is a rare malignant tumor arising in the olfactory epithelium. Forty cases observed at the Institut Gustave-Roussy from 1956 to 1987 are reported. This tumor usually grows slowly and is usually local, but it is important to be aware of the possibility of lymph node involvement (17%) and, particularly, of rapid development of distant metastases (25%), usually within 6 months. CT scan, and more recently, NMR have proved to be of value in choosing the surgical approach. In view of the usual point of departure, a combined neurosurgical and transfacial approach seems to be a satisfactory approach for obtaining oncological control of the lesion. The role of chemotherapy is discussed. The main prognostic factors seem to be the size of the lesion, the intracranial extension, and the lymph node involvement.
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PMID:Olfactory esthesioneuroma: a report of 40 cases. 339 65

A case of esthesioneuroepithelioma was investigated ultrastructurally and immunohistochemically, using antibodies against neurofilament protein (NFP), glial fibrillary acidic protein (GFAP), keratin, neuron-specific enolase (NSE), S-100 protein (S-100), and tyrosine hydroxylase (TH). The tumor initially manifested as an epidural mass in the anterior cranial fossa in a 64-year-old man, and about 3 1/2 years later, autopsy further revealed extensive metastases to the lymph nodes of the neck and thoracic cavity. In the cranial and nasal cavities, the tumor was composed of fairly uniform, ill-defined cells arranged in nests which were surrounded by a fibrovascular stroma. These histological features were reproduced in the metastatic tumor nodules with frequent occurrence of tubular arrangements of the tumor cells. Ultrastructurally, two different cell types were well recognized by their characteristic morphological features, which were reminiscent of sensory neurons and sustentacular cells of the olfactory epithelium. No dense-cored secretory granules were observed in the tumor cells. Immunohistochemically, the tumor showed a variable number of cells positive for NFP, keratin, NSE and S-100. NFP was present in a relatively small number of cells, which were found diffusely in the nests. Keratin was observed in the cells mainly located at the periphery. NSE-positive cells tended to form irregular clusters in the center. A few S-100-positive cells were found, without any particular arrangement.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Esthesioneuroepithelioma: a tumor of true olfactory epithelium origin. An ultrastructural and immunohistochemical study. 343 22

The clinicopathologic features of 21 olfactory neuroblastomas are reviewed with emphasis on variables of potential diagnostic or prognostic value. The patients ranged in age from 9 to 66 years (median: 49 years); 57% were women. At the time of diagnosis, one tumor was Kadish stage A, 11 were stage B, and nine were stage C. Nineteen patients had extensive surgical resections, but in six instances these were considered incomplete. Six patients (29%) developed local recurrences and eight (38%) had metastases. Ten patients (48%) were alive and free of disease from 10 to 239 months (median: 58 months) after diagnosis. Seven (33%) died of tumor, with a duration of survival ranging from 1 to 142 months (median: 27 months). A fibrillary intercytoplasmic back-ground was the most useful diagnostic feature microscopically and was present, at least focally, in 18 of 21 tumors. A silver stain for neuronal processes was helpful when fibrils could not be seen on hematoxylin- and eosin-stained sections. Homer-Wright rosettes, when present, also aided in diagnosis but were well formed in only six tumors. The only clinical feature that correlated with prognosis was whether the neoplasm had been completely excised at initial presentation. Tumor necrosis was the only histologic feature correlating with prognosis, but neither association was statistically significant. Metastases, clinical stage, mitotic rate, and nuclear pleomorphism showed no relationship to survival in this series.
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PMID:Olfactory neuroblastoma. A clinicopathologic study of 21 cases. 409 Nov 74

A patient with olfactory neuroblastoma had extensive involvement of the nasopharynx, sinuses and orbit, and cervical metastasis. After surgical biopsy and excision of metastatic disease, she was treated with chemotherapy: three cycles of high-dose cisplatin (100 mg/sq m) and infusion of fluorouracil (1 g/sq m/day for five days). Subsequent treatment included definitive radiation therapy followed by three additional cycles of chemotherapy. The patient is free of disease three years after initiating therapy. This case report demonstrates the potential efficacy of planned combined modality therapy, including early chemotherapy in the control of locally advanced, unresectable olfactory neuroblastoma.
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PMID:Olfactory neuroblastoma. Chemotherapy and radiotherapy for extensive disease. 654 69

We present the first case report of an olfactory neuroblastoma (esthesioneuroblastoma) diagnosed by cytologic examination. The patient was a 40-year-old male who had a 13-year history of "adenocarcinoma" of the nasal cavity until the correct diagnosis of olfactory neuroblastoma was made cytologically from pleural fluid shortly before his death. The cells had the typical features of rosette formation, scanty elongated cytoplasm, clustering of cells and nuclear compression resulting in an "onion-skin" appearance. Surgical specimens, several biopsies and fine needle aspiration of a metastatic deposit in a lymph node all showed, retrospectively, features of esthesioneuroblastoma. Electron microscopy showed membrane-bound dense-core secretory granules. Autopsy findings revealed multiple metastases but no tumor at the original site; that tumor had been treated with high-dose radiation therapy as well as systemic chemotherapy. Olfactory neuroblastoma is a rare tumor, but it is important to recognize because it has a better prognosis than the more commonly encountered malignancies of the nose.
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PMID:Cytologic diagnosis of olfactory neuroblastoma. Report of a case with multiple diagnostic parameters. 657 48

A case of a tumor of the anterior cranial fossa, which had clinical, radiological and surgical features of an olfactory meningioma, but histological findings of a metastasis from intestinal carcinoma, is reported. Differential radiological features between meningiomas and metastases are briefly examined and the role of the dura mater in metastatic spreading is discussed.
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PMID:[Metastases of intestinal carcinoma simulating a meningioma of the olfactory perforation]. 662 34

The biologic behavior of olfactory neuroblastoma in 21 persons treated at the Mayo Clinic, Rochester, Minn, from 1960 to 1980 is reviewed. Follow-up data of five years or more are available for 19 cases. Findings showed the tendency of these tumors to spread submucosally and intracranially without obvious involvement of the anterior cranial fossa dura. The aggressive nature of this lesion has not been appreciated. Metastatic disease occurred in 62% and local recurrence in 57%. Long-term follow-up showed that recurrent or metastatic disease could occur up to ten years after initial diagnosis. The five-year survival rate was 58%. Only four patients who have been follow-up for more than five years were without local recurrence or metastasis. This review should prompt a change in the current attitudes toward treatment of this tumor.
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PMID:Olfactory neuroblastoma. Biologic and clinical behavior. 663 53


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