Vol.102 No.8 contentsPRACTICA OTO-RHINO-LARYNGOLOGICA
Vol. 102 No. 8 August 2009
Use of a CyberKnife to Effectively Treat, Small Cell Neuroendocrine Carcinoma (SNEC)
in the Ethmoidal Sinus Showing Acute Intracranial Invasion
Noritsugu Ono, Hidenori Yokoi, Kyoko Tazaki, Kaori Kase and Hiroshi Yoshikawa
(Juntendo University Urayasu Hospital)
Izumi Koike
(Yokohama Cyberknife Center)
Katsuhisa Ikeda
(Juntendo University School of Medicine)
A 51-year-old man had a chief complaint of left epistaxis and orbital pain. Anterior rhinoscopy showed a tumor in the left nasal cavity. CT showed a mass in the left ethmoid sinus, and the nasal septum and skull base showed thinning. Ga cintigraphy showed accumulation only in the left nasal cavity. Thereafter, MRI showed a mass with acute intracranial invasion occurring two-week with a period. We biopsied the nasal tumor, and the diagnosis was SNEC. Because the tumor acutely extended to the intracranial space, the patient developed convulsion. We performed treatment for convulsion with glyceol, rinderon and phenytoin. After radiotherapy with cyberknife effectively reduced the size both of the primary lesion and intracranial lesion, abdominal CT detected liver metastasis. The patient is currently receiving chemotherapy with irinotecan and cisplatin.
Key words :cyberknife, small cell neuroendocrine carcinoma (SNEC), acute intracranial invasion