嗅神経芽細胞腫2症例

概要

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Olfactory neuroblastoma is an uncommon malignant tumor the pathological diagnosis of which is often difficult because of the wide range of histological features. We report two cases of olfactory neuroblastoma in which the clinical course was unusual. A 70-year-old male had had surgical excision of a malignant nasal tumor without an accurate pathological diagnosis 15 years earlier. Immunohistochemical staining revealed morphological features of olfactory neuroblastoma in both the first nasal tumor (1974) and the recurrent tumor (1989). Because of respiratory insufficiency he received only radiation therapy and is alive, with tumor, 11 months after irradiation.After surgical excision of an intracranial meningioma, a 57-year-old male had a Galdwell-Luc operation for sinusitis and nasal polyp ; biopsy showed chronic inflammation. The specimen from the ethmoid sinus, however, was reported to be an olfactory neuroblastoma. A specimen of the intracranial tumor was reexamined, and the diagnosis was corrected to olfactory neuroblastoma. The patient was treated again with surgical extirpation by lateral rhinotomy and with radiation. The patient is alive 10 months later with no evidence of local recurrence or metastasis.