Esthesioneuroblastoma (es-THEE-zee-o-NOO-row-blas-TOE-muh) is a rare type of cancer that begins in the part of the brain that interprets smell (olfactory bulb). Esthesioneuroblastoma is also called olfactory neuroblastoma.

Esthesioneuroblastoma, which can occur at any age, often causes a tumor to form behind the nose that may affect the sinuses. People with esthesioneuroblastoma may lose the sense of smell, have frequent nosebleeds and experience difficulty breathing through their nostrils.

Esthesioneuroblastoma treatments include surgery, radiation and chemotherapy.

  • Teamwork. At Mayo Clinic, ear, nose and throat specialists work with other experts, such as radiation oncologists, medical oncologists, neurosurgeons, radiologists and pathologists, in a multidisciplinary team to care for people with esthesioneuroblastoma. Other professionals are included as needed.
  • Experience. Esthesioneuroblastoma is a rare type of cancer. Mayo Clinic doctors have experience diagnosing and treating esthesioneuroblastoma.
  • A full range of treatment options to consider. Mayo Clinic doctors will work with you to review all of your treatment options and choose the treatment that best suits your needs and goals. The range of treatments offered to people with esthesioneuroblastoma includes surgery, radiation and chemotherapy.
  • Comprehensive cancer center. Mayo Clinic Cancer Center meets strict standards for a National Cancer Institute comprehensive cancer center, which recognizes scientific excellence and a multidisciplinary approach to cancer prevention, diagnosis and treatment.

Mayo Clinic in Rochester, Minn., is ranked among the Best Hospitals for cancer by U.S. News & World Report. Mayo Clinic in Jacksonville, Fla., and Mayo Clinic in Scottsdale, Ariz., are ranked high performing for cancer by U.S. News & World Report.

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Mayo Clinic offers rapid, coordinated diagnostic testing and assessments by a team of skilled doctors with specialized expertise in esthesioneuroblastoma, using the latest testing options.

Esthesioneuroblastoma diagnosis may involve:

  • Physical examination. A careful history of your signs and symptoms and an examination of your eyes, nose and throat give doctors clues that aid in diagnosis.
  • Using a tiny camera to see in your nose and throat. During an endoscopy examination, a thin, flexible tube (endoscope) is inserted in your mouth or your nose. The tube is equipped with a tiny camera that allows your doctor to look for signs of a tumor.
  • Imaging tests. Imaging tests such as CT, MRI and positron emission tomography (PET) help doctors visualize the location of your esthesioneuroblastoma and determine whether it has spread.
  • Removing a sample of tissue for testing. A biopsy is a procedure to remove a sample of the tumor tissue for testing. Biopsy for esthesioneuroblastoma is usually done during surgery to remove the tumor. After laboratory analysis, doctors can confirm whether the tumor is esthesioneuroblastoma.

Esthesioneuroblastoma diagnosis can be difficult, since it's a very rare type of cancer and it can appear very similar to other, more-common types of cancer that occur in the head and neck.

Treatment for esthesioneuroblastoma typically involves surgery and radiation. Chemotherapy is another treatment option.

Surgery

Mayo Clinic's head and neck surgeons and neurosurgeons have significant experience in performing esthesioneuroblastoma operations, which are often challenging procedures. Surgical techniques vary, depending on the tumor's location, and may include:

  • Surgery to open the skull and gain access to the tumor. A craniotomy is a procedure to remove a portion of the skull in order to access the tumor. For a large tumor that's grown into delicate structures nearby, such as the eye or the brain, this procedure may offer the best outcome.
  • Minimally invasive surgery through the nose. Endoscopic surgery uses a long tube equipped with a camera (endoscope) to access a tumor. The endoscope is inserted in your nose, and special surgical tools are passed through the tube. In some cases, an incision in the mouth may be necessary to assist the endoscope.

Radiation therapy

Radiation therapy uses high-energy beams, such as X-rays or protons, to kill cancer cells. People with esthesioneuroblastoma often undergo radiation therapy after surgery to kill any cancer cells that might remain in the head and neck.

Radiation therapy can also be used alone or in combination with chemotherapy if esthesioneuroblastoma is too large or too advanced to be removed through surgery.

Because esthesioneuroblastoma is located near many delicate structures in your head, such as your brain and your eyes, radiation beams must be aimed precisely to focus on cancer cells and spare the healthy tissue nearby. Mayo Clinic offers many advanced forms of radiation treatment planning and delivery, such as intensity-modulated radiation therapy.

Chemotherapy

Chemotherapy uses drugs to kill cancer cells. In people with esthesioneuroblastoma, chemotherapy can be used before surgery to shrink a larger tumor in order to make it easier to remove. In some cases, chemotherapy is combined with radiation therapy after surgery to kill any cancer cells that may remain.

Mayo Clinic works with hundreds of insurance companies and is an in-network provider for millions of people. In most cases, Mayo Clinic doesn't require a physician referral. Some insurers require referrals or may have additional requirements for certain medical care. All appointments are prioritized on the basis of medical need.

A team of specialists at Mayo Clinic in Arizona will work together to identify the appropriate esthesioneuroblastoma treatment approach for your needs. The team may include specialists in otorhinolaryngology, neurological surgery, medical oncology, radiation oncology and pathology.

For appointments or more information, call the Central Appointment Office at 800-446-2279 (toll-free) 8 a.m. to 5 p.m. Mountain Standard Time, Monday through Friday or complete an online appointment request form.

A team of specialists at Mayo Clinic in Florida will work together to identify the appropriate esthesioneuroblastoma treatment approach for your needs. The team may include specialists from neurosurgery, otolaryngology, medical oncology, radiation oncology and pathology.

For appointments or more information, call the Central Appointment Office at 904-953-0853 8 a.m. to 5 p.m. Eastern time, Monday through Friday or complete an online appointment request form.

A team of specialists at Mayo Clinic in Minnesota will work together to identify the appropriate esthesioneuroblastoma treatment approach for your needs. The team may include specialists from otorhinolaryngology, neurosurgery, radiation oncology, oncology and pathology.

For appointments or more information, call the Central Appointment Office at 507-538-3270 7 a.m. to 6 p.m. Central time, Monday through Friday or complete an online appointment request form.

See information on patient services at the three Mayo Clinic locations, including transportation options and lodging.

Doctors and researchers at Mayo Clinic are studying the latest diagnosis and treatment techniques for esthesioneuroblastoma.

Cancer research is conducted in coordination with the Mayo Clinic Cancer Center. The Mayo Clinic Cancer Center receives funding from the National Cancer Institute and is designated as a comprehensive cancer center — recognition for an institution's scientific excellence and multidisciplinary resources focused on cancer prevention, diagnosis and treatment.

Publications

See a list of publications by Mayo Clinic authors on esthesioneuroblastoma on PubMed, a service of the National Library of Medicine.

Feb. 05, 2013