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J Neurol Surg Rep 2014; 75(02): e194-e199
DOI: 10.1055/s-0034-1372472
Case Report
Georg Thieme Verlag KG Stuttgart · New York

Synchronous Esthesioneuroblastoma and Growth-Hormone-Secreting Pituitary Macroadenoma: Combined Open and Endoscopic Management

Costanza J. Valdes
1   Department of Otolaryngology – Head and Neck Surgery, McGill University, Jewish General Hospital, Montreal, Quebec, Canada
,
Marc A. Tewfik
1   Department of Otolaryngology – Head and Neck Surgery, McGill University, Jewish General Hospital, Montreal, Quebec, Canada
,
Marie-Christine Guiot
2   Department of Neuropathology, McGill University, Montreal Neurological Institute, Montreal, Quebec, Canada
,
Salvatore Di Maio
3   Division of Neurosurgery, McGill University, Jewish General Hospital, Montreal, Quebec, Canada
› Author Affiliations
Further Information

Publication History

18 June 2013

24 January 2014

Publication Date:
21 July 2014 (online)

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Abstract

Background Esthesioneuroblastoma is an uncommon malignant neoplasm that arises from the olfactory neuroepithelium. In this article we report a case of esthesioneuroblastoma presenting concomitantly with a growth-hormone (GH)-secreting pituitary macroadenoma.

Results A 52 year old woman underwent surgery for suspected nasal polyps. Intralesional debulking of an intranasal tumor disclosed a low-grade esthesioneuroblastoma. Magnetic resonance imaging (MRI) demonstrated a large nasal and intracranial tumor, in addition to a separate sellar and suprasellar tumor. The patient was frankly acromegalic. She underwent a first-stage gross total resection of the esthesioneuroblastoma via a combined extended subfrontal and extended endonasal approach, followed by focused radiation therapy. She then returned for endoscopic removal of the GH-secreting pituitary macroadenoma.

Conclusion The combined open and endoscopic management of this patient is described and a review of the literature presented. To our knowledge this is the first case of synchronous esthesioneuroblastoma and macroadenoma, in this case GH secreting, described in the literature.

Keywords

esthesioneuroblastoma - pituitary adenoma - acromegaly - endoscopic skull base surgery - craniofacial resection

Note

Salvatore Di Maio had full access to all the data in the study and final responsibility for the decision to submit for publication.


 

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