An olfactory neuroblastoma (esthesioneuroblastoma) is staged using the Kadish staging system. A patient with bilateral nasal cavity involvement extending into the ethmoid sinuses but NOT beyond the nasal cavity/paranasal sinuses is staged as:

• A Kadish Stage B — disease confined to nasal cavity and paranasal sinuses ✓
• B Kadish Stage A — disease confined to nasal cavity only
• C Kadish Stage C — disease extending beyond the paranasal sinuses (orbit, skull base, intracranially)
• D Kadish Stage D — cervical lymph node or distant metastasis

Explanation

Kadish staging of olfactory neuroblastoma: Stage A = tumor confined to the nasal cavity; Stage B = tumor involving nasal cavity AND paranasal sinuses; Stage C = tumor extends beyond nasal cavity/sinuses (orbit, skull base, intracranial, cervical nodes); Stage D (modified Kadish, by Morita) = cervical lymph node or distant metastasis. Treatment for all stages is combined surgery (craniofacial resection, now increasingly endoscopic for Stage A/B) + radiotherapy. Chemotherapy (cisplatin-based) is added for Stage C/D. 5-year survival: Stage A ~90%, Stage B ~70%, Stage C ~50%.

Reference: Dhingra Diseases of Ear, Nose and Throat, 7th ed.

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Written and medically reviewed by the StethoPrep medical team.