Management of Locally Advanced Esthesioneuroblastoma in a Pregnant Woman

• Author(s): Guerreiro, I. ; Vieira, C. ; Soares, A. ; Braga, A. ; Jácome, M. ; Dinis, J.
• Date: 2019
• Persistent ID: http://hdl.handle.net/10400.16/2362
• Origin: Repositório Científico da Unidade Local de Saúde de Santo António (ULSSA)
• Document Type: Journal article
• Language: English
• Contributor(s): Repositório Científico da Unidade Local de Saúde de Santo António

Description

Esthesioneuroblastoma (ENB) is a rare malignant tumor that commonly develops in the upper nasal cavity. Standard treatment is not established, especially in locally advanced disease which portends the worse prognosis. Hereby, we report a case of a 27-year-old, 23-week pregnant woman, with a 2-month history of progressively growing right cervical lymphadenopathy, nasal obstruction, anosmia, frequent episodes of epistaxis, and right frontal headache. Imagiological evaluation revealed a lesion with 7×5,2×3,2 cm in the nasal fossae with extension to the ethmoidal complex and right olfactive fend and invasion of the endocranial compartment associated with lymphadenopathy. The biopsy revealed a high-grade EBN. Neoadjuvant chemotherapy with cisplatin and etoposide was administrated during pregnancy and continued after delivery up to 6 cycles of treatment with partial response. Radiotherapy followed, with complete response. This case report is intended to highlight that a high grade of suspicion should be kept in the presence of nonspecific symptoms of nasal obstruction, anosmia, facial pain, and/or headache and focus that chemotherapy is an important component of a combined-treatment modality for locally advanced ENB that can be used during pregnancy in a lifesaving situation.