[Diagnostic difficulties of the patient with sinonasal tract tumor; therapeutic dilemmas - a case report and up to date review]

Abstract

Esthesioneuroblastoma (ENB) is a rare malignancy unique to the sinonasal tract. It arises from the olfactory epithelium and has a tendency to originate from one side of the nasal cavity and paranasal sinuses with frequent extension into the cranial cavity and orbit. There is a bimodal age distribution between 11 and 20 years and between 51 and 60 years. ENB accounts for approximately 2-3% of intranasal cancers. Due to the non-specific nature of the initial presentation and slow growth of the tumor, patients often have a long history before diagnosis. Physicians including pathologists are not always aware of distinctive features of ENB especially radiographic, histologic and immunohistochemical characteristics. Additional difficulty can be the fact that Esthesioneuroblastoma can histologically mimic many tumors within the sinonasal tract. We report on a 38-year-old male patient with a Kadish stage C tumor with frontal lobe invasion. The patient underwent a craniofacial resection with a combined head neck and neurosurgeon team. After the surgery postoperative radiotherapy was used. The aim of this study is to present the natural history of the malignancy, the diagnostic process, treatment and prognosis, based on the literature review.