TITLE:
Successful Treatment with 177Lutetium-Dotatate and Maintenance Octreotide in a Patient with Esthesioneuroblastoma with Central Nervous System Invasion: Case Report and Review of the Literature
AUTHORS:
Gabriela Dombrowski, Laura Fernandes Ferreira Dalcin, Francisco Assis Coelho, Patricia Massucheto Ledesma, Daniel Herchenhorn
KEYWORDS:
Esthesioneuroblastoma, Olfactory Neuroblastoma, Peptide Receptor Radionuclide Therapy, PRRT, 177Lutetium
JOURNAL NAME:
International Journal of Otolaryngology and Head & Neck Surgery,
Vol.12 No.1,
January
18,
2023
ABSTRACT: This article presents a case of a patient with relapsed
esthesioneuroblastoma (ENB), an aggressive rare tumor that arises from the
specialized sensory epithelial olfactory cells in the skull base area, which
was initially treated with endoscopic surgery, followed by adjuvant
radiotherapy. After local relapse, new surgical approaches and subsequent lines
of platin-based chemotherapy were performed.
A PET-CT with 68GALIUM DOTATATOC (PET-DOTATOC) showed intense uptake of disease, compatible with
the presence of somatostatin receptors, in the face, nodes, liver,
bones, and meningeal area. Treatment with 4 cycles of 177Lutetium-Dotatate
was performed, followed by maintenance octreotide, with a major radiological
and clinical response that is lasting more than 1 year after treatment. This
article describes a rare case of a skull-base tumor, with multiple recurrences,
in which disease control was achieved with a
targeted Peptide Receptor Radionuclide Therapy (PRRT) with 177Lutetium-Dotatate, and discusses
factors that could influence the incorporation of this form of therapy. Previous
case reports proved the potential efficacy of this therapy usually given for
low-grade neuroendocrine tumors and will be carefully reviewed.