Esthesioneuroblastoma (es-THEE-zee-o-NOO-row-blas-TOE-muh) is a very rare type of cancer that occurs in the nasal cavity. It is thought to begin in the part of the brain that interprets smell (olfactory bulb). Esthesioneuroblastoma is also called olfactory neuroblastoma.
Esthesioneuroblastoma can occur at any age and generally begins as a tumor in the nasal cavity and may grow or extend into the sinus, eyes and brain. People with esthesioneuroblastoma can lose their sense of smell, have frequent nosebleeds and experience difficulty breathing through their nostrils as the tumor grows. Esthesioneuroblastoma treatments include surgery, radiation and chemotherapy.
Early referral for an intranasal biopsy is key to early diagnosis. A patient with a unilateral nasal obstruction and/or a recurrent epistaxis (nose bleeds) lasting longer than 1-2 months should undergo a thorough nasal evaluation by an otolaryngologist. Both CT and MRI studies usually are required in the majority of patients. Because the details of bony erosion are better demonstrated by CT images, while soft tissue structures are better seen in MRI, both studies usually are required in the majority of patients. Once the radiologic studies are completed, a biopsy will be taken after administering a topical anesthesia.
The optic nerves, due to their close proximity to the olfactory nerves, are at risk of being invaded by the tumor as well as being injured during either radical surgery or radiation. Therefore, a preoperative ophthalmological evaluation is always required to obtain a "baseline" for vision and evaluate any possible existing visual deficits.
Treatment for esthesioneuroblastoma typically involves surgery and radiation. Chemotherapy is another treatment option that may be used.
Generally, a neurosurgeon and a head and neck surgeon work together as a team to remove esthesioneuroblastoma safely and effectively. Surgical techniques vary, depending on the tumor's location.
Radiation therapy uses high-energy beams, such as X-rays or protons, to kill cancer cells. People with esthesioneuroblastoma often undergo radiation therapy after surgery to kill any microscopic cancer cells that might remain in the head and neck.
Radiation therapy can also be used alone or in combination with chemotherapy if surgery isn't an option due to other health concerns or if the cancer is too advanced to be removed through an operation.
Because esthesioneuroblastoma is located near many critical structures in your head, such as your brain and your eyes, radiation beams must be aimed precisely to focus on cancer cells and spare the healthy tissue nearby.
Chemotherapy uses drugs to kill cancer cells. In people with esthesioneuroblastoma, chemotherapy is combined with radiation therapy after surgery to kill any cancer cells that may remain, especially for cancers that are very aggressive or extensive.