Esthesioneuroblastoma: A Case Report

Introduction: Esthesioneuroblastoma is a rare malignant neoplasm arising from neuroendocrine cells of the olfactory epithelium, being located preferably at the uppermost portion of the nasal septum and cribriform lamina. The higher incidence between the second and sixth decades of life, with no gender predominance. The most common symptoms are epistaxis, unilateral nasal obstruction, and anosmia. The treatment includes excision associated with radiotherapy.

Objectives: This study aims to report a case of a patient with esthesioneuroblastoma treated in our service and approach.

Resumed Report: A 35-year-old male patient, sought our service presenting epistaxis in the left nasal cavity, a moderate amount. The patient reported in the anamnesis recurrent episodes of epistaxis and unilateral nasal obstruction for 2 years. Nasofibroscopy was seen as purplish polypoid lesion, crispy on the left nasal fossa. We ordered computed tomography and magnetic resonance imaging of the paranasal sinuses and showed a lesion with soft tissue density limited to the upper canal, without invasion of adjacent structures. The patient underwent surgical treatment by endoscopic route and performed resection of the lesion with macroscopic margin of safety. The histopathological and immunohistochemical examination confirmed the diagnosis. The patient is at the beginning of the radiotherapy sessions.

Conclusion: Esthesioneuroblastoma is a potentially curable by surgical resection and radiotherapy malignancy. Whenever we are faced with a unilateral mass, we must rule out malignancy, even when these tumors have a more indolent appearance. The rarity of the tumor has hindered the development of a homogeneous therapeutic strategy.