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  • Title: Esthesioneuroblastoma metastatic to the thoracic intradural and extradural space.
    Author: Arnold PM, Habib A, Newell K, Anderson KK.
    Journal: Spine J; 2009 May; 9(5):e1-5. PubMed ID: 18805062.
    Abstract:
    BACKGROUND CONTEXT: Ethesioneuroblastoma (ENB) is a rare tumor of the olfactory epithelium that has been shown to metastasize mostly to the cervical lymphatics, with only infrequent spread to other locations. We report a rare case of ENB characterized by recurrence and distant metastasis to the T7-T8 intradural and extradural space. PURPOSE: To report a rare case of recurrent ENB metastatic to the thoracic intradural and extradural space. STUDY DESIGN/SETTING: Case report with a review of the literature. METHODS: A 64-year-old man with recurrent ENB presented with chronic pain in the neck, shoulder, and back. His neurologic exam was normal. Computed tomography of the chest showed no pulmonary metastasis and a high-attenuation spinal canal mass at T8 was noted on magnetic resonance imaging. A laminectomy at T7-T8 was performed for resection of a large epidural mass. A tumor was seen penetrating through the dura, and a midline durotomy was performed for resection of a large intradural mass. Frozen section and permanent stains were consistent with metastatic ENB. RESULTS: The postoperative period was uneventful, and included pain management and physical therapy, followed by chemotherapy and radiation. The patient remains free of spinal recurrence 2 years after surgery. CONCLUSIONS: Metastasis of ENB to the spinal column is rare, and of those instances, 80% are localized to the cauda equina. Recurrent ENB metastatic to the thoracic intradural and extradural space is extremely rare, and was successfully treated with surgical resection.
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