A 34-year-old female patient with a history of maternal grandfather died of pulmonary fibrosis.
Sinusitis seven years earlier.
She consulted with her ENT for a 14-month history of rhinorrhea and rapidly progressive epistaxis.
Median rhinoscopy showed a mass in the right nasal fossa with a polypoid appearance that was very bleeding at the contact, occupying the entire right nostril, seems to connect with the septum and the middle turbinate,
Biopsy was positive for esthesioneuroblastoma.
A CT scan of the head and neck showed a polypoid mass of 4 centimeters (cm) in the right nostril and cavum.
The MRI of the head and neck shows a space occupying lesion that strikingly obliterates the cavity and extends from the level of the nostrils to the back, putting in contact with the predetermined musculature.
1.
A chest CT and a bone scintigraphy without pathology were performed as an extension study.
It is classified as Kadish Stage C.
She underwent functional endoscopic surgery with the pathological anatomy of esthesioneuroblastoma.
Postoperative CT showed polypoid thickening of the mucosa in the right maxillary sinus, with no evidence of malignancy in the right frontal sinus.
1.
It was decided as treatment with external radiotherapy, by means of a Lineal Accelerator with photons of 6 and 15 MV, with wedges after virtual simulation and 3D on adjuvant CT tissue compensation.
The tumor bed received an overall dose of 60 Gy in 30 cases, with a scheme of 2 Gy/fraction, 5 episodes per week.
Tolerance was good, with maximum skin toxicity G1, mucosa G2 and oropharyngeal G2.
Currently, 6 months have passed from irradiation, maintaining complete response.
