An Unusual Presentation of Esthesioneuroblastoma in a Young Pregnant Female

Esthesioneuroblastoma is a rare neuroepithelial tumor arising from the olfactory epithelium in the cribriform plate or nasal cavity. It accounts for 1-5% of cases of malignant neoplasms of the nasal cavity.

A 20-year-old pregnant female presented with painful loss of vision in both eyes, on imaging diagnosed as meningioma. There was a progressive increase in pain along with diminution of vision to the extent of complete loss of vision in the right eye.

In view of increasing proptosis with progressive complete loss of vision in the left eye also, she consulted the neurosurgery department at a tertiary care hospital where a follow-up of contrast-enhanced computerised tomography was made. Histopathology of fluid obtained after craniotomy showed esthesioneuroblastoma. In view of intracranial space-occupying lesion applying pressure on the optic nerve, intravenous methylprednisolone (1 g, IV stat X 3 days) was given. She underwent extensive radiotherapy but died within 3 months of diagnosis.

This case highlights the progressive and fatal course of olfactory neuroblastoma. As it can present with the complex symptoms related to ocular and nasal sites, timely referral of patients presenting with visual symptoms along with nasal involvement (frequent epistaxis) to otorhinolaryngologists is very important.