Esthesioneuroblastoma

An esthesioneuroblastoma is a relatively rare type of cancerous tumor that forms in the upper portion of the nasal cavity. This critical area is separated from the brain by a bone with tiny holes that allow for the passage of nerves that control the sense of smell (olfactory nerves). Also known as an olfactory neuroblastoma, the tumor originates in the olfactory nerves.

Because esthesioneuroblastomas develop in a sensitive area near the brain, this nasal cancer requires highly specialized treatment. Tampa General Hospital offers a full spectrum of care for adults and children with brain tumors and other complex neurological conditions. Tampa General Hospital’s Neuroscience Institute and Ear, Nose and Throat (ENT) Institute feature internationally respected neurosurgeons and ENT surgeons who are supported by a robust team of specially trained and certified nurses, technicians and other medical professionals. For 2024-25, TGH is recognized as One of the Nation's Best Hospitals for Cancer Care by U.S. News & World Report.

What Can Cause an Esthesioneuroblastoma?

Like all types of cancer, esthesioneuroblastomas arise when healthy cells undergo abnormal changes that cause them to ignore the signals that normally control their growth. As the cells continue to grow and divide uncontrollably, the excess cells build up, bind together and form masses. Scientists have not yet identified the precise mechanisms that trigger the cellular mutations that lead to the development of esthesioneuroblastomas.

What Are the Symptoms of an Esthesioneuroblastoma?

The symptoms of an esthesioneuroblastoma can include:

• Loss of sense of smell (anosmia)
• Frequent nosebleeds
• Difficulty breathing through the nostrils

As the tumor grows, it may begin to press on sensitive tissues in the nasal cavity, sinuses and brain, which can lead to additional symptoms such as eye pain, vision loss, ear pain and headaches.

How Is an Esthesioneuroblastoma Diagnosed?

If an esthesioneuroblastoma is suspected based on the symptoms, a physician will typically perform a medical history review and examine the patient’s nose, eyes, head and neck. The diagnostic process may also include:

• An endoscopic examination – The physician will insert a thin, flexible tube with a miniature camera attached to the end (endoscope) into the nose, then use the camera to view the interior of the nasal cavity and sinuses and check for abnormalities.
• Imaging tests– Magnetic resonance imaging (MRI) scans and positron emission tomography (PET) scans can help the physician evaluate the location, extent and spread of a tumor.
• A biopsy – The physician will insert special instruments through the nose and remove a sample of the suspicious tissue for analysis by a pathologist in a lab.

What Are the Treatment Options for an Esthesioneuroblastoma?

The main form of treatment for an esthesioneuroblastoma is skull base surgery to remove the tumor. The surgical techniques, which can vary based on the location and size of the tumor, can include:

• Endoscopic surgery – The surgeon will insert an endoscope and specialized surgical tools into the nose to visualize and remove the nasal portion of the tumor.
• Craniotomy– The surgeon will remove a small portion of the skull to access and remove the tumor.

Radiation therapy may be delivered after surgery to target any remaining cancer cells and help prevent a recurrence. If an esthesioneuroblastoma cannot be surgically removed due to its location, size or other concerns, radiation therapy may be used alone or in combination with chemotherapy.

Choose TGH for World-Class Care

At TGH, our neurosurgeons and ENT surgeons work closely with other specialists, including radiation oncologists, medical oncologists, radiologists and pathologists, to provide comprehensive skull base surgical care for our patients with esthesioneuroblastomas and other complex neural tumors. If would like to consult with a specialist at TGH, contact us at (800) 822-3627 to set up an appointment.