Presentation
Nausea, vomiting, meningism.
Patient Data
A large irregular heterogeneously enhancing mass traverses in the cribriform plate, involving the nasal cavity, obliterating ethmoid air cells and extending into the lower aspect of the anterior cranial fossa.
There is peritumoral cystic appearance with thin rim enhancement.
Both frontal lobes are elevated with overlying parenchymal edema and distortion of the frontal horns of the lateral ventricles.
Post-contrast FLAIR shows abnormal packing meningeal enhancement extending along the falx, and there is also abnormal leptomeningeal enhancement along the inferior surface of both frontal lobes.
Case Discussion
Esthesioneuroblastoma, or olfactory neuroblastoma, is a rare tumor of the olfactory epithelium. This MRI demonstrates the characteristic peritumoural cystic appearance with intracranial invasion.
A biopsy of the patient confirmed the diagnosis of esthesioneuroblastoma (estimated grade 3 or 4), and the patient underwent surgical resection.