Presentation
Right nasal obstruction with epistaxis.
Patient Data
Heterogeneously enhancing soft tissue mass of the right ethmoid air cells and nasal cavity with no intracranial or orbital extension.
The right nasoethmoidal mass elicits an isosignal to muscles on T1, heterogeneous high signal on T2 and T2 fat sat with restricted diffusion and moderate heterogeneous enhancement on postcontrast sequences. Obstruction of the ostia of the ipsilateral paranasal sinuses with accumulation of mucous secretions.
No invasion of the anterior cranial fossa, orbits or across the midline to the contralateral nasal cavity.
Case Discussion
MRI features of heterogeneously enhancing nasoethmoidal soft tissue mass, pathologically proven as olfactory neuroblastoma.
Olfactory neuroblastomas, also known as esthesioneuroblastomas, are slow-growing tumors arising from the basal layer of the olfactory epithelium in the superior recess of the nasal cavity.
CT is particularly useful in assessing bony destruction, although it cannot distinguish olfactory neuroblastomas from other tumors that arise in the same region.
MRI is useful when an intracranial extension is present.