An Uncommon Case of Pediatric Esthesioneuroblastoma Presenting as SIADH: 18F-FDG PET/CT in Staging and Post-Therapeutic Assessment.

Marie Fosbøl,Jeppe Friborg,Andreas Kjær,Anders Bilde,Eric Von Benzon,Christian Von Buchwald,Lise Borgwardt

doi:10.3390/diagnostics8010008

Marie Fosbøl, Jeppe Friborg + Show 5 more

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https://doi.org/10.3390/diagnostics8010008

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Abstract

Esthesioneuroblastoma (ENB) is an uncommon neuroendocrine tumor originating from the olfactory neuroepithelium and accounts for 3–6% of all intranasal tumors [1]. ENBs can be locally aggressive and cause invasion and destruction of surrounding structures. Histological grading and clinical stage at presentation are highly predictive of survival and especially presence of lymph node and distant metastases are determining prognostic factors [2,3,4,5]. Thus, reliable imaging is essential in these patients. Conventional imaging modalities for staging ENB are magnetic resonance imaging (MRI) and computed tomography (CT). However, fluorine-18 fluoro-2-deoxy-d-glucose positron emission tomography/CT (18F-FDG PET/CT) has been reported as a valuable adjunct and was found to upstage 36% of ENB patients compared to conventional imaging [6]. We present a case demonstrating the diagnostic work-up and follow-up with 18F-FDG PET/CT in a young patient with ENB with a highly atypical clinical presentation.

Highlights

Esthesioneuroblastoma (ENB) is an uncommon neuroendocrine tumor originating from the olfactory neuroepithelium and accounts for 3–6% of all intranasal tumors [1]
Besides symmetrical FDG uptake in the pharyngeal lymphatic tissue, which is considered benign, there were no sites of increased FDG uptake in the cervical lymph nodes
Presenting symptoms are usually local tumor expansion, such as nasal obstruction epistaxis thisIncase, disease was diagnosed early due to hyponatremia caused by syndrome of inappropriate antidiuretic hormone (SIADH), and epistaxis this the case, the disease was diagnosed early due to hyponatremia caused by but

Summary

Introduction

Esthesioneuroblastoma (ENB) is an uncommon neuroendocrine tumor originating from the olfactory neuroepithelium and accounts for 3–6% of all intranasal tumors [1]. Initial scan—(left,middle): CT and fused 18 F-FDG PET/CT, coronal view; (right): 18 F-FDG The patient was referred to 18 F-FDG PET/CT Histological and immunohistochemical examination of tumor material were consistent with an ectopic esthesioneuroblastoma Hyams grade 1 positive for chromogranin, synaptophysin, neuron-specific enolase, calretinin, and vasopressin.

Results

Conclusion