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Diagnosis: Esthesioneuroblastoma Esthesioneuroblastoma is otherwise known as olfactory neuroblastoma and is an unusual tumor seen in up to 5% of nasal cavity malignancies. It has a bimodal age distribution with one peak from 10 to 20 years of age and again from 50 to 60 years of age. They occur in the superior nasal cavity and often extend into the ethmoidal air cells and the maxillary sinuses. Sphenoid sinus involvement is less common. They may also extend into the anterior cranial fossa, the orbit, and the cavernous sinus. Post-obstructive sinus disease is always present. They are expansile, destructive masses which tend to remodel bone and have isointense T1 signal and slightly increased T2 signal. Contrast enhancement is variable. If the lesion has spread intracranially, cysts may be seen along the intracranial margin. Craniofacial resection is curative in 90% of cases. The differential diagnosis of superior nasal cavity mass includes adenoid cystic carcinoma, inverting papilloma, nasopharyngeal carcinoma, lymphoma, and metastases. Nasopharyngeal carcinoma and metastasis would tend to destroy rather than remodel adjacent bone. Related Cases
Som PM, Lidov M, Brandwein M, Catalano P, et al. Sinonasal esthesioneuroblastoma with intracranial extension: marginal tumor cysts as a diagnostic MR finding. AJNR; Aug 1994; 15(7):p1259-62.
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