Management of Locally Advanced Esthesioneuroblastoma in a Pregnant Woman

Abstract EN

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.