What Is an Esthesioneuroblastoma (Olfactory Neuroblastoma)?
An esthesioneuroblastoma (ENB) is a rare type of skull base tumor. Esthesioneuroblastoma is also known as olfactory neuroblastoma. ENB tumors grow in your nose. They most often grow where your nose meets the base of your skull. These tumors usually grow upward toward your brain or down toward your eyes and sinuses. Esthesioneuroblastomas are a type of head and neck cancer. They are not brain cancer.
Esthesioneuroblastoma Causes
Esthesioneuroblastoma tumors affect around one in 2.5 million people each year. ENB tumors are most common in people ages 40–60. However, experts don’t know what causes them. They also don’t know what any risk factors are.
Why Choose University of Utah Health
University of Utah Health is the only academic medical center in Utah and the Mountain West. We are internationally recognized as a leading research and teaching center, and are proud to train most of Utah’s health care professionals. We use innovative research and a personalized approach to power our medical care. Our team of experts and researchers includes specialists in skull-base surgery, neurosurgery, oncology, and radiology. Our multidisciplinary training, experience, and focus helps you get the best possible outcome.
Esthesioneuroblastoma Symptoms
Esthesioneuroblastoma symptoms depend on the tumor’s size. Symptoms are similar to allergies, sinus infections, or other conditions that can block your nose:
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Congestion that only affects one side
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Frequent nosebleeds
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Reduced or lost sense of smell
As the tumor grows into nearby areas, you may experience other symptoms:
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Face pain, vision changes, sinus pressure, or headaches
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Recurrent sinus infections, ear pain, or neck swelling
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Seizures
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Vision changes, such as double vision, eye bulging, or loss of vision
When Should I See a Provider?
Early symptoms of an ENB tumors are similar to common conditions, like allergies or colds. You may want to contact a provider if you have symptoms that do not improve over time:
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Congestion only on one side (Congestion from colds or allergies normally affects both sides of the nose.)
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Lost sense of smell for longer than 2–3 weeks
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Symptoms that do not improve or resolve after 3–4 weeks of medication
How Is Esthesioneuroblastoma Diagnosed?
We use a step-by-step diagnostic process that starts with a physical exam. We ask about your symptoms and medical history. We may order a few tests to help us with your diagnosis:
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Nasal endoscopy—We use a thin, flexible tube with a tiny camera on the end to look inside your nose.
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Imaging tests—CT or MRI scans can help show the tumor’s size, location, and shape.
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Whole-body imaging—PET scans can see if your tumor has spread.
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Tissue biopsy—Your provider may take samples from your tumor for testing.
These tests tell us how fast the cancer is growing or spreading. They also help us understand how likely the tumor is to respond to treatment. The results help us grade the tumor based on how quickly it’s growing. We use the Hyams grading system to describe how the tumor cells look and act. Grades I and II have much better outcomes than the higher grades:
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Grade I—These grow the slowest and look similar to normal cells.
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Grade II—Cells look more abnormal with some signs of growth.
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Grade III—These show active growth and a greater danger of spreading.
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Grade IV—The cells are growing very quickly with the highest risk of spreading.
Scan and biopsy results also show us if the cancer has spread. This is measured in stages:
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Stage A—The cancer is only in the nose.
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Stage B—The cancer spread to the sinuses.
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Stage C—The cancer spread to other structures, like the brain and eyes.
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Stage D—The cancer spread to distant parts of the body.
Can Esthesioneuroblastoma Be Cured?
ENB tumors are curable. Success often depends on how early you get a diagnosis and what grade your cancer is. After we find out the tumor’s grade and stage, we will give you personalized treatment recommendations for your specific needs.
Find an ENB Specialist
10 Resulting Health Care Providers
Jeremiah Alt, MD, PhD, FACS, FARS
Robert C. Kersten, MD, FACS, FASOPRS
Hilary McCrary, MD, MPH
Sarah T. Menacho, MD, MBA
Kristine A. Smith, MD, FRCSC
Esthesioneuroblastoma Treatment
We use a combination of treatments for esthesioneuroblastoma. Treatments focus on destroying or removing the tumor. Surgery followed by radiation therapy is the main treatment. We may also use chemotherapy. We offer different methods depending on your tumor’s size:
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Endoscopic surgery uses a tiny camera and special tools to remove the tumor through your nose. This is the most common approach, depending on the size and location of the tumor.
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Open surgery (craniotomy) temporarily removes a small piece of your skull to reach the tumor. This may happen along with endoscopic surgery to ensure we remove all of the tumor.
Your provider may suggest non-surgical treatments:
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Chemotherapy—Your provider may suggest anticancer drugs to shrink the tumor before surgery.
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Radiation therapy—We often use this therapy after surgery. It can destroy cancer cells that may have spread to other areas, like lymph nodes. The goal is to prevent the cancer’s return.
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Stereotactic radiosurgery (SRS)—SRS uses high‑energy beams to focus on the tumor. The beams focus on the tumor and avoid nearby structures, such as your eyes or brain. We use SRS to either destroy or shrink the tumor before surgery.
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U of U Health's Skull Base Tumor Second Opinion Program
Facing a medical diagnosis can be overwhelming. Our world class experts offer second opinions on skull base tumors.
Make an Appointment
Fill out our online form to schedule a consultation with one of our anterior skull base tumor specialists. You don’t need a referral, but you should check with your insurance first as some insurance companies require referrals.
Get a Consultation
Not located in Utah? If you have a diagnosis, you can contact us for a consultation. Once we have scheduled the call, we will set up a phone call to discuss your diagnosis with you. We will request that you send us copies of relevant tests:
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CT or MRI images
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Results from your vision test
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Any other testing you may have had
Contact the Destination Care Program
The Destination Care Program is an initiative by U of U Health focusing on care for our out-of-state patients. We are here to help you find the services and information you need. Feel free to contact us:
Email: DestinationCare@hsc.utah.edu
Phone: 801-587-6365