Overview
Olfactory neuroblastoma, also called esthesioneuroblastoma, is a rare cancer that arises from the specialized smell (olfactory) tissue high in the nasal cavity, at the junction with the base of the skull. Although uncommon, it is an important sinonasal skull-base cancer because of its location and the way it is treated.
Symptoms often develop gradually and can include persistent one-sided nasal blockage, nosebleeds, and a change or loss of smell. Because the tumor sits at the roof of the nose near the brain and eye, evaluation and treatment require skull-base expertise.
Care is multidisciplinary and individualized. After diagnosis and staging, treatment commonly combines surgery, which may be endoscopic, open, or a combination, with radiation therapy and, in some cases, systemic treatment, along with skull-base reconstruction and long-term surveillance. This page is educational and does not replace specialist evaluation.
What the tumor is
Olfactory neuroblastoma (esthesioneuroblastoma) is a rare cancer that arises from olfactory tissue at the roof of the nasal cavity, where the nose meets the base of the skull. Because of this location, it can extend toward the eye socket and the front of the brain, which is why it is managed as a skull-base cancer.
Symptoms
Symptoms often build gradually and commonly include persistent one-sided nasal blockage, recurrent nosebleeds, and a change in or loss of smell. Larger tumors can cause eye symptoms such as tearing, bulging, or vision changes. One-sided, progressive nasal symptoms warrant evaluation.
Living with olfactory neuroblastoma (esthesioneuroblastoma)? The next step is a quiet, unhurried conversation.
Endoscopy, imaging, and biopsy
Nasal endoscopy allows the tumor to be seen and assessed, while CT and MRI define its extent and its relationship to the eye, brain, and skull base. A biopsy with expert pathology review establishes the diagnosis. Imaging is generally obtained before biopsy when a skull-base tumor is suspected.
Staging and multidisciplinary review
Once diagnosed, the tumor is staged to determine its extent, including whether it has spread. Treatment planning is multidisciplinary, drawing on skull-base surgery, radiation oncology, and medical oncology, and may include review of imaging and pathology by the team.
Surgery, radiation, and systemic therapy
Treatment commonly combines surgery to remove the tumor with radiation therapy. Depending on the tumor's location and extent, surgery may be endoscopic, open, or a combination. Systemic therapy is used in selected cases. The specific plan is individualized to the tumor and the patient.
Living with olfactory neuroblastoma (esthesioneuroblastoma)? The next step is a quiet, unhurried conversation.
Skull-base reconstruction and surveillance
Removing a tumor at the roof of the nose often requires reconstruction of the skull base to separate the nasal cavity from the space around the brain and prevent a CSF leak. Because the tumor can recur, long-term surveillance with examination and imaging is an essential part of care.
When to seek care
Seek prompt evaluation for persistent one-sided nasal blockage, recurrent nosebleeds, or a new loss of smell. Seek emergency care for heavy nosebleeds that do not stop, sudden vision changes, or severe headache, which require immediate attention.
Medical review
This page is a patient-education resource reviewed by the responsible Norelle Health clinician before publication. It does not replace an in-person evaluation. If symptoms are severe or rapidly worsening, seek immediate medical care.
Living with olfactory neuroblastoma (esthesioneuroblastoma)? The next step is a quiet, unhurried conversation.
Common Symptoms
Treatment Approach
Treatment for olfactory neuroblastoma (esthesioneuroblastoma) is individualized based on the severity of symptoms, anatomical considerations, and patient goals. Our specialists may consider:
- 01Surgery by an endoscopic, open, or combined approach
- 02Radiation therapy
- 03Systemic therapy in selected cases
- 04Skull-base reconstruction after tumor removal
- 05Coordinated, multidisciplinary planning and long-term surveillance
Specialists who treat olfactory neuroblastoma (esthesioneuroblastoma)
Dr. Adrian Ong
MD
Board-Certified Facial Plastic & Reconstructive and Head & Neck Surgeon
Dr. Adrian Ong is a board-certified surgeon who practices exclusively on the face, head, and neck, with expertise spanning rhinoplasty, sinus surgery, facial trauma, reconstruction, and sleep surgery.
- Functional and aesthetic rhinoplasty (including revision)
- Sinus surgery and complex revision sinus surgery
- Facial trauma and nasal fractures
- Head and neck cancer surgery and microvascular reconstruction
Also caring for this area
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Clinical References
These independent resources from medical and professional organizations offer further reading. They are provided for general education and do not replace a consultation with a clinician.
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