This is an olfactory neuroblastoma (esthesioneuroblastoma). Gross pathologic examination of specimens from the left middle turbinate, left ethmoid sinus, left frontal sinus mucosa, and skull base revealed fragments of tan-pink, soft and hard tissues. Histopathologic examination of the tissues revealed neuropil formation with intermediate-sized round cells. Scattered mitotic figures were present. No evidence of anaplasia or pleomorphism was seen. The tissues stained positively for Synaptophysin.

This patient underwent anterior cranial base resection and reconstruction with a left-sided nasal septal flap in 2019 following diagnosis of a left-sided esthesioneuroblastoma involving the skull base with intracranial extension. The patient ultimately decided against adjuvant radiotherapy despite recommendations, but did undergo serial imaging every 6 months post-operatively. Two years post-operatively, the patient endorsed ongoing complete olfactory loss. The patient eventually expired.

Co-author:
Mason Soeder