Olfactory neuroblastoma is a very rare malignant form of tumor that occurs in olfactory cells. These cells are present on the roof or the backside of the nose causing nasal obstructions and related sinusitis initially.
Often, these tumors are confused with nasal polyps and, therefore, the diagnosis is late. The growth of tumors is also subjective. Sometimes they grow very slowly, while on the other hand, they can quickly metastasize and make the patient lose their sense of smell, sight, taste completely.
If the tumors grow quickly and reach the advanced stage, they can also cause severe deformation of the face.(1)
Is There A Surgery For Olfactory Neuroblastoma & Life Expectancy Of Someone With It?
As far as treatment for this type of cancer is concerned, radiation therapy and chemotherapy are not as effective as in other forms of cancer and surgery is the best way to get rid of cancerous tumors. However, constant examinations and tests are extremely important since these tumors are recurrent.
Surgical intervention is the first choice of treatment for this type of cancer. In most cases, the first treatment for nasal cancers, such as olfactory neuroblastoma, is to remove the tumor. Usually, this treatment also clears a lot of tissues around cancer to help ensure that all cancers have been cleared. Extensive local resection and medial maxillary resection are two procedures that are usually performed. These are invasive procedures that may require reconstruction of part of the face, but these provide the best chance of long-term survival. In some cases, less invasive surgery, such as endoscopic surgery using thin and flexible light-emitting tubes, may be feasible.(4)(5)
Adjuvant Therapy For Olfactory Neuroblastoma
Radiation therapy is often recommended before or after surgical treatment to reduce the risk of relapse. Some researchers in the early stages of the disease recommend using only the surgical method of treatment, others recommend conducting radiation therapy before or after resection, which can increase the likelihood of suppressing local regional growth of the tumor even in the early stages.
Interestingly, some research suggested the use of chemotherapy but not radiation therapy leading to improved outcomes. There is currently no consensus on the preferred treatment. However, most often the doctor resorts to combination treatment; and the most common access is craniofacial resection.
Various combinations of chemotherapy, radiation therapy and surgical methods are used depending on the prevalence of the tumor. It is believed that olfactory neuroblastoma is sensitive to chemotherapy, which is usually used as neoadjuvant therapy in the late stages of the disease. Some doctors recommend a chemotherapy course to reduce the size of the tumor before removing it.(4)
Symptoms Of Olfactory Neuroblastoma
Some experts have characterized the symptoms of this condition in several stages. Because this cancer develops in the nasal cells, it also leads to various symptoms in the oral, facial, neurological, and cervical regions.
These signs and symptoms include loss of teeth, mouth ulcers, runny nose, the presence of nodules or masses in the neck and facial swelling. The symptoms, therefore, will depend on the degree of cancer spread and the prognosis is also highly uncertain. Research shows that there are some cases where people have lived with this type of cancer for almost 20 years, and on the other hand there are some cases where cancer has spread so quickly that death has occurred within a few months.(2)
Diagnosis Of Olfactory Neuroblastoma
To diagnose olfactory neuroblastoma, several tests and examinations of the nasal area are done. These tests involve Computed Tomography (CT), Magnetic Resonance (MRI), and Positron Emission Tomography scan (PET).
These tests can reveal the growth of these tumors within nasal cavity cells and also see how far they have spread. Additional tests, such as biopsy and endoscopy, can also help in the complete diagnosis of the disease.
The complex of diagnostic measures requires the participation of an ophthalmologist and a neuropathologist, which is due to the clinical course of the tumor. The main thing in establishing and confirming a diagnosis, as for any oncological pathology, are morphological diagnostic methods. Cytological research methods with this type of neoplasm are informative in 50-70% of cases. The histological conclusion made after the biopsy of the tumor finally confirms the diagnosis.(3)
- Song X, Wang J, Wang S, Yan L, Li Y. Prognostic factors and outcomes of multimodality treatment in olfactory neuroblastoma. Oral Oncology. 2020;103:104618.
- Yin Z, Wang Y, Wu Y, et al. Age distribution and age-related outcomes of olfactory neuroblastoma: a population-based analysis. Cancer management and research. 2018;10:1359.
- Peckham M, Wiggins R, Orlandi R, Anzai Y, Finke W, Harnsberger H. Intranasal esthesioneuroblastoma: CT patterns aid in preventing routine nasal polypectomy. American Journal of Neuroradiology. 2018;39(2):344-349.
- Wu J-Y, Chiou J-F, Ting L-L. Chemo-radiotherapy for olfactory neuroblastoma: cases report and literature review. 2019.
- Harvey RJ, Nalavenkata S, Sacks R, et al. Survival outcomes for stage‐matched endoscopic and open resection of olfactory neuroblastoma. Head & neck. 2017;39(12):2425-2432.
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