Esthesioneuroblastoma: problems with diagnosis and management

Esthesioneuroblastoma is an uncommon tumor arising from the olfactory epithelium of the nasal cavity. Since most cases present clinically with non-specific findings such as unilateral nasal obstruction and intermittent epistaxis, esthesioneuroblastoma is often mistaken for other diseases of the nasal cavity. Histological confirmation of the disease can also be difficult. The aggressive nature of esthesioneuroblastoma is evidenced by frequent local recurrences and occasional distant metastases--further complicating the management of this tumor. The otolaryngologist should possess a high index of suspicion for this rare, but devastating malignancy. Guidelines for the evaluation and treatment are presented.