MR of esthesioneuroblastoma (olfactory neuroblastoma) and appearance after craniofacial resection

To analyze the MR characteristics of a series of patients with esthesioneuroblastoma and discuss the typical surgery and its postoperative MR appearance. The MR studies of 15 patients with the pathologic diagnosis of esthesioneuroblastoma (also known as olfactory neuroblastoma) were retrospectively reviewed and correlated with CT and surgical findings. The postoperative MR studies of 10 patients who underwent craniofacial resection were also reviewed. In all cases the tumors arose in the superior nasal cavity and extended into the ethmoid cells. In some instances the tumors extended into the other paranasal sinuses, orbits, anterior cranial fossa, and cavernous sinus. The tumors were typically expansile and destructive in their growth patterns. Compared with brain gray matter, the tumors were hypointense on T1-weighted images and isointense to hyperintense on T2-weighted images. Nine tumors were heterogeneous and 6 were homogeneous. Contrast enhancement ranged from mild to marked. MR was useful for characterizing the various tissues and distinguishing fluid in the postoperative nasal cavity. Esthesioneuroblastoma, although an uncommon tumor, may be suspected in lesions of the superior nasal cavity demonstrating both expansile and destructive growth properties. The MR findings are otherwise nonspecific. MR is the imaging modality of choice for depicting local tumor extension and evaluating for recurrence after craniofacial resection.