ESTHESIONEUROBLASTOMA - A REPORT OF 7 CASES

The biologic behavior of esthesioneuroblastoma in seven patients, trea ted from 1978 to 1989, is reviewed. The patients were initially treate d with surgical resection (2 cases), radiation alone (1 case) or a com bination of radiation and surgery (4 cases). The radiation dose ranged from 30 to 62 Gy. Operations were performed via a transmaxillary appr oach (2 cases), lateral rhinotomy approach (3 cases) and craniofacial approach (I case). Four of the seven patients experienced local recurr ence, occurring after disease-free intervals as long as 6 years. The o ther three patients died of distant metastasis within one year after i nitial treatment. The effectiveness of radiation therapy varied, and i n some patients a dose of 60 Gy was not enough to control microscopic disease. One patient developed bone marrow metastases which was fatal due to the ensuing pancytopenia. One patient developed a brain metasta sis. Hyams' histopathologic staging of the tumor appeared to be relate d to prognosis.