Recurrent Olfactory Neuroblastoma in Remote Leptomeninges, Mimicking Intracranial Meningioma

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• 作者：You-Sub Kim¹ ; Shin Jung¹ ; ^{sjung@chonnam.ac.kr} ; Woo-Youl Jang¹ ; Kyung-Hwa Lee² ; Kyung-Sub Moon¹ ; In-Young Kim¹
• 关键词：En-bloc ; Metastasis ; Olfactory neuroblastoma ; Remote leptomeninges
• 刊名：World Neurosurgery
• 出版年：2016
• 出版时间：December 2016
• 年：2016
• 卷：96
• 期：Complete
• 页码：612.e9-612.e14
• 全文大小：2217 K
• 卷排序：96

文摘

Olfactory neuroblastoma (ONB) is an uncommon neoplasm that arises from olfactory epithelium in the nasal cavity near the cribriform plate. Although local recurrence or direct extension along olfactory epithelium and metastasis to the central nervous system has been reported, remote leptomeningeal metastasis is quite rare. In our report of a leptomeningeal metastasis of ONB without recurrence of primary site, we discuss the possible pathogenesis of this rare phenomenon with a review of the literature.Case DescriptionA 56-year-old woman was admitted with epistaxis. Magnetic resonance imaging revealed a mass in the right cribriform plate and ethmoid sinus with intracranial extension. She was primarily treated with craniofacial resection followed by radiotherapy. Gross total resection was achieved, but annual follow-up magnetic resonance imaging showed a new enhancing mass in the left parietal meninges mimicking meningioma without local recurrence at 5 years after the first operation. A second operation was performed, and pathologic examination confirmed the lesion as metastatic olfactory neuroblastoma.ConclusionsONB is a locally aggressive tumor, but it also potentially spreads to remote leptomeninges via blood or cerebrospinal fluid. Therefore, careful evaluation is needed not to misdiagnose a meningioma and delay the treatment. Moreover, understanding the route of remote leptomeningeal metastasis and en-bloc resection of tumor at first operation might reduce leptomeningeal metastasis, irrespective of surgical corridors.