Esthesioneuroblastomas (ENBs) are undifferentiated tumours of neuroectodermal origin derived from the olfactory epithelium. Inconsistent histologic presentations can lead to the controversy regarding the exact histologic origin of ENBs, and this ambiguity can confound clinical and prognostic decisions. These tumours often display varying biologic activity ranging from indolent growth, with patient survival exceeding 20 years, to a highly aggressive neoplasm capable of rapid widespread metastasis, with survival limited to a few months. Due to the rare and complex nature of ENB, multiple opinions exist regarding the etiology, optimal staging system and treatment modalities. We have come across a case of Esthesioneuroblastoma, presenting as recurrent nasal mass with bleeding in a 50 yr old male. Histological presentation was unusual but the diagnosis was confirmed by Immunohistochemistry.
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