Esthesioneuroblastoma care at Mayo Clinic

At Mayo Clinic, specialists work together to provide you with expert, whole-person care.

Diagnosis at Mayo Clinic

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. A biopsy may be performed by inserting special tools through your nose to access the cancer, or a biopsy may be done during surgery to remove the cancer. 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.

Treatments at Mayo Clinic

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, thin tube equipped with a camera (endoscope) to access a tumor using minimally invasive surgery. The endoscope is inserted in your nose, and special surgical tools are passed through the tube.

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. In some cases, this may shrink a cancer enough to make surgery an option.

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 proton therapy and 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.

Palliative care

Palliative care is specialized medical care that focuses on providing relief from pain and other symptoms of a serious illness. At Mayo Clinic, palliative care specialists work with you, your family and your other doctors to provide an extra layer of support that complements your ongoing care.

Palliative care is provided by a team of doctors, nurses and other specially trained professionals. Palliative care teams aim to improve the quality of life for people with cancer and their families. This form of care is offered alongside curative or other treatments you may be receiving.

Feb. 11, 2016
References
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  2. Winn HR. Esthesioneuroblastoma. In: Youmans Neurological Surgery. 6th ed. Philadelphia, Pa.: Saunders Elsevier; 2011. http://www.clinicalkey.com. Accessed Jan. 21, 2016.
  3. Snyderman C, et al. Olfactory neuroblastoma (esthesioneuroblastoma). http://www.uptodate.com/home. Accessed Jan. 21, 2016.
  4. Lucas JT, et al. Proton radiotherapy for pediatric and adolescent esthesioneuroblastoma. Pediatric Blood Cancer. 2015;62:1523.
  5. Cook AJ. Allscripts EPSi. Mayo Clinic, Rochester, Minn. Sept. 22, 2015.