Esthesioneuroblastoma – delayed postoperative radiosurgery for recurrence at long-term

Skull Base Region Olfactory Groove
Histopathology Esthesioneuroblastoma
Prior Surgical Resection Yes
Pertinent Laboratory Findings N/A

Case description

The patient was a 40-year-old male who presented with a 1-year history of intermittent nasal obstruction. Progressive symptoms led to a transnasal biopsy demonstrating esthesioneuroblastoma. He underwent a craniofacial resection with negative margins for a Kadish stage C, Hyams grade 3 tumor and received adjuvant radiation of 5040 cGy in 28 fractions along with Cytoxan, etoposide, and cisplatin chemotherapy ( Figure 2.6.1 ). He was followed with positron emission tomography (PET) and magnetic resonance imaging (MRI), demonstrating recurrent local disease 7 years later ( Figure 2.6.2 ). Due to the presence of other medical comorbidities, he underwent stereotactic radiosurgery (SRS) treatment for recurrence (7 isocenters; volume, 38.4 cm 3 ; 10-Gy margin; 25-Gy maximum dose) ( Figure 2.6.3 ).

Radiosurgery Machine Gamma Knife – Model B
Radiosurgery Dose (Gy) 10, at 50% isodose line
Number of Fractions 1

Figure 2.6.1.

Initial postoperative axial postcontrast T1-weighted image after adjuvant radiotherapy.

Figure 2.6.2.

Interval axial postcontrast T1-weighted image at 7 years demonstrating local disease recurrence.

Figure 2.6.3.

Imaging of the treatment plan.

Apr 6, 2024 | Posted by in GENERAL RADIOLOGY | Comments Off on Esthesioneuroblastoma – delayed postoperative radiosurgery for recurrence at long-term

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