title: Synchronous esthesioneuroblastoma and growth-hormone-secreting pituitary macroadenoma: combined open and endoscopic management.
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.
authors.affiliation: Department of Otolaryngology - Head and Neck Surgery, McGill University, Jewish General Hospital, Montreal, Quebec, Canada.
authors.forename: Costanza J
authors.initials: CJ
authors.lastname: Valdes
authors.affiliation: Department of Otolaryngology - Head and Neck Surgery, McGill University, Jewish General Hospital, Montreal, Quebec, Canada.
authors.forename: Marc A
authors.initials: MA
authors.lastname: Tewfik
authors.affiliation: Department of Neuropathology, McGill University, Montreal Neurological Institute, Montreal, Quebec, Canada.
authors.forename: Marie-Christine
authors.initials: MC
authors.lastname: Guiot
authors.affiliation: Division of Neurosurgery, McGill University, Jewish General Hospital, Montreal, Quebec, Canada.
authors.forename: Salvatore
authors.initials: S
authors.lastname: Di Maio
keywords: acromegaly; craniofacial resection; endoscopic skull base surgery; esthesioneuroblastoma; pituitary adenoma