Management of Locally Advanced Esthesioneuroblastoma in aPregnant Woman

Esthesioneuroblastoma (ENB) is a rare malignant tumor that commonly develops in the upper nasal cavity. Standard treatment isnot established, especially in locally advanced disease which portends the worse prognosis. Hereby, we report a case of a 27-year-old, 23-week pregnant woman, with a 2-month history of progressively growing right cervical lymphadenopathy, nasal obstruction,anosmia, frequent episodes of epistaxis, and right frontal headache. Imagiological evaluation revealed a lesion with 7×5,2×3,2 cm inthe nasal fossae with extension to the ethmoidal complex and right olfactive fend and invasion of the endocranial compartmentassociated with lymphadenopathy. The biopsy revealed a high-grade EBN. Neoadjuvant chemotherapy with cisplatin andetoposide was administrated during pregnancy and continued after delivery up to 6 cycles of treatment with partial response.Radiotherapy followed, with complete response. This case report is intended to highlight that a high grade of suspicion shouldbe kept in the presence of nonspecific symptoms of nasal obstruction, anosmia, facial pain, and/or headache and focus thatchemotherapy is an important component of a combined-treatment modality for locally advanced ENB that can be used duringpregnancy in a lifesaving situation.