Intranasal Esthesioneuroblastoma: CT Patterns Aid in Preventing Routine Nasal Polypectomy.

Area of Science:

• Radiology
• Oncology
• Head and Neck Surgery

Background:

• Esthesioneuroblastoma is a rare neuroectodermal tumor originating in the nasal cavity's olfactory recess.
• Intranasal esthesioneuroblastoma can mimic benign nasal lesions on imaging.
• Accurate diagnosis is crucial as esthesioneuroblastoma requires more extensive surgery than benign conditions.

Purpose of the Study:

• To define distinguishing computed tomography (CT) characteristics of isolated intranasal esthesioneuroblastoma.
• To differentiate esthesioneuroblastoma from benign olfactory recess lesions using CT findings.
• To guide appropriate surgical intervention for intranasal esthesioneuroblastoma.

Main Methods:

• Retrospective review of eight histologically confirmed intranasal esthesioneuroblastoma cases.
• Inclusion of twelve control patients with non-esthesioneuroblastoma olfactory recess lesions.
• CT and MR imaging review, with CT findings compared between esthesioneuroblastoma and control groups.
• Two blinded readers assessed CT criteria for esthesioneuroblastoma suspicion.

Main Results:

• Esthesioneuroblastoma cases showed three key CT findings: unilateral intranasal polypoid lesion in the olfactory recess, asymmetric olfactory recess widening, and extension to the cribriform plate.
• CT criteria demonstrated good diagnostic accuracy for predicting esthesioneuroblastoma (AUC = 0.85 and 0.81 for two readers).
• These CT patterns effectively distinguished esthesioneuroblastoma from benign olfactory recess diseases.

Conclusions:

• Esthesioneuroblastoma can present as a well-defined intranasal mass unilaterally widening the olfactory recess.
• CT imaging patterns are valuable for predicting esthesioneuroblastoma.
• Utilizing these CT criteria can prevent unnecessary surgeries by enabling correct initial operative management.