What Is an Olfactory Neuroblastoma?

Olfactory neuroblastoma is a rare malignant tumor derived from the mucosal neuroepithelial cells in the olfactory region. The disease is rare, the cause is unknown, and it is more common in adults without significant gender differences. The malignancy of this disease is higher, the prognosis is worse with younger age, and the prognosis is worse with larger lesion range.

Basic Information

Visiting department

Cancer Radiation Therapy

Multiple groups

Adults

Common causes

The cause is not clear

Common symptoms

Nosebleeds, unilateral nasal congestion

Etiology of Olfactory Neuroblastoma

The etiology of this disease is not clear, and most scholars believe that it is derived from residual embryonic cells.

Clinical manifestations of olfactory neuroblastoma

Olfactory neuroblastoma can occur at any age and is more common in adults. There is no significant difference between men and women. The clinical manifestations are non-specific, common nosebleeds, unilateral nasal congestion, and some patients have headaches, excessive tearing, blurred vision, decreased or lost olfactory symptoms, neck masses and other symptoms. On examination, most of the patients saw pale red or gray-red polyp-like masses at the top of the nasal cavity and middle nasal passages, which were easy to bleed.

Olfactory neuroblastoma test

1.CT scan When the tumor is small and confined to the nasal cavity, the CT scan density is more uniform and the boundary is clearer; when the tumor is larger, the center is often a bit of necrosis, the density of the tumor is uneven, and swollen bone destruction or infiltration is seen around Bone destruction.
2. Magnetic Resonance Examination (1) The tumor traveled along the olfactory nerve, showing swollen and invasive growth, and most of the affected bones showed significant destructive changes.
The tumor center is mostly located in the upper nasal cavity or the anterior ethmoid sinus, which can penetrate into the anterior cranial fossa across the intracranial and extracranial growth, and is usually an irregular soft tissue mass.
(2) TlWI signal is slightly lower, T2WI signal is slightly higher, the larger boundary is more unclear, the signal is more uneven, and cystic changes, bleeding, calcification, and ossification are seen as low signal shadows.
3. Pathological examination The tumor is located in the submucosa, mostly lobular or cord-like, surrounding the neurofibrillary matrix, surrounded by fibrosing fibrous stroma surrounding the proliferating blood vessels. The highly malignant tumor is accompanied by obvious nuclear aberrations and nuclear fission. Increase and necrosis.

Olfactory neuroblastoma diagnosis

The main points of diagnosis are as follows.
1. Common nosebleeds, unilateral nasal congestion, and some patients have headaches, excessive tearing, blurred vision, decreased or lost smell, and neck masses.
2. CT and MRI examinations can clarify the scope of the tumor and the invasion of adjacent tissues.
3. Pathological examination showed that the tumor cells were characterized by small circles and small spindles, which were mostly lobular or cord-like, with intervals of abundant vascular fibrous interstitial.

Olfactory neuroblastoma treatment

The incidence of this disease is low and no consensus has been reached on standard treatment options. The vast majority of scholars recommend a comprehensive treatment plan of surgery combined with chemoradiation.
Surgery can be performed by nasal incision or craniofacial resection. However, due to the complexity of the anatomical structure of the tumor origin, complete resection is difficult. Postoperative radiotherapy and / or chemotherapy are required to improve the effect of tumor control.

Prognosis of olfactory neuroblastoma

The 5-year and 10-year survival rates of olfactory neuroblastoma can reach 62.1% and 45.6%, respectively. Due to the characteristic of invasive growth of the tumor, recurrence and metastasis are still common even after comprehensive treatment. The younger the age, the worse the prognosis. The larger the lesion, the worse the prognosis.