Esthesioneuroblastoma

Treatment

The primary treatment for esthesioneuroblastoma is usually surgery, followed by chemotherapy and radiation. A collaborative team of experienced medical and surgical specialists determine the best treatment for each patient. That team can include skilled specialists from otorhinolaryngology, neurosurgery, and oncology.

Surgery

Head and neck surgeons generally work with neurosurgeons to remove esthesioneuroblastomas. The usual surgical treatment involves a craniofacial resection. In this procedure, a neurosurgeon makes an incision in the skull (craniotomy), and a head and neck surgeon makes an incision along the side of the nose (lateral rhinotomy).

For select small tumors, surgeons can feed a small flexible instrument called an endoscope through the nose to remove the cancer. This is the transnasal endoscopic approach. Surgeons treat metastatic tumors to the neck and parotid gland by removing the affected tissue (parotidectomy) and/or neck dissection.

Radiation Therapy

Mayo Clinic uses state-of-the-art radiation therapies including intensity-modulated radiation therapy (IMRT) and Gamma Knife™ radiosurgery. These technologies allow Mayo Clinic specialists to treat the cancer effectively while limiting the amount of radiation to important healthy tissues such as the eyes, optic nerves, brain, brain stem, and spinal cord. This careful focus is particularly important for cancers such as esthesioneuroblastoma. IMRT also enables delivery of high-dose radiation to inoperable tumors.

Chemotherapy

Cancer-fighting drugs may be used to kill cancer cells in high-grade tumors and those that have spread outside the primary tumor. Chemotherapy can also make radiation therapy more effective by making cancer cells more sensitive to radiation therapy. The drugs may be given by mouth, into a vein, or both.