Olfactory neuroblastoma

Abstract

A frontal lobe disorder and a runny nose A 56-year-old woman presented with progressive apathy, expressive aphasia, urinary incontinence, and a subtle right hemiparesis. She had a recent history of clear rhinorrhea and frequent nosebleeds. CT and MRI scan revealed a large mass in the left nasal cavity extending into the frontal lobe (figure 1). The diagnosis of olfactory neuroblastoma was confirmed by transnasal biopsy (figure 2). A combined treatment of chemotherapy and radiotherapy was suggested. Before treatment could be initiated, the patient died of a major hemorrhage in the tumor.Olfactory neuroblastoma is a rare (0.4 per million per year) neural crest tumor thought to arise from the olfactory neuroepithelium. Treatment generally consists of resection and radiotherapy with or without chemotherapy. 1,2 Figure 1Coronal CT and sagittal MRI (A) Coronal CT scan shows a mass in the left nasal cavity, paranasal sinuses, and frontal lobe with destruction of the cribriform plate and medial orbital wall. There is vasogenic edema and subfalcine herniation. (B) T1-weighted contrast-enhanced MRI shows a dumbbell-shaped enhancing mass in the left frontal lobe, the nasal cavity, and the sphenoid sinus. This Neurology ® special interest Web site is the go-to source for tracking science and politics of neurology beyond the United States, featuring up-to-the-minute blogs, scholarly perspectives, and academic review of developments and research from Neurology journals and other sources.