Olfactory Neuroblastoma-A Report of Four Cases

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Four cases with olfactory neuroblastoma (ONB) during the 13-year period from 1991 to 2004 are reported. The patients were 27, 68, 67 and 52 year-old men. The chief complaints of all cases were unilateral nasal obstruction and epistaxis. To make a final diagnosis, immunohistochemical examination was very useful in addition to light microscopic findings. MRI is a valuable examination to assess intracranial involvement. As ONB is known to be radiosensitive, all patients were treated with preoperative radiotherapy (45 to 50.4 Gy), followed by craniofacial resection with reconstruction using Galleal flap. The efficacy of chemotherapy has not been established for this tumor, therefore, our cases were not treated with chemotherapeutic drugs. Two cases had local recurrence over 5 years after the initial treatment. In conclusion, we suggest that long-term follow-up is essential because of the high rate of local recurrence or metastasis, and that to control this disease, though chemotherapy might be considered, the combination of craniofacial surgery and radiotherapy is effective.
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