Huge sphenoid sinus olfactory neuroblastoma: a case report

Area of Science:

• Oncology
• Otorhinolaryngology
• Pathology

Background:

• Olfactory neuroblastoma is a rare cancer of the olfactory neuroepithelium, comprising about 5% of paranasal sinus malignancies.
• Common symptoms include nasal obstruction, bleeding, loss of smell, rhinorrhea, and headaches.

Observation:

• A 79-year-old man presented with over a year of bilateral nasal congestion.
• Nasoendoscopy revealed a large, smooth tumor in the nasopharynx extending to the nasal septum.
• Pathology confirmed olfactory neuroblastoma after endoscopic resection.

Findings:

• Olfactory neuroblastomas typically originate in the cribriform plate or superior turbinate.
• Originating solely in the sphenoid sinus is exceptionally rare, with only four prior cases reported.
• This case represents the largest reported sphenoid sinus olfactory neuroblastoma, presenting with cranial neuropathies and headache.

Implications:

• This case expands the known anatomical origins of olfactory neuroblastoma.
• It underscores the need for thorough investigation in cases of persistent sinonasal symptoms, especially with neurological involvement.
• Further research into sphenoid sinus olfactory neuroblastoma is warranted due to its rarity and potential for significant enlargement.