Esthesioneuroblastoma (olfactory neuroblastoma) arises from the olfactory neuroepithelium at the cribriform plate. The Kadish staging system Grade C is defined as:

• A Tumor confined to nasal cavity
• B Tumor extending into paranasal sinuses
• C Tumor extending beyond nasal cavity and sinuses (orbit, skull base, intracranial, or cervical nodes) ✓
• D Tumor with distant metastasis

Explanation

The Kadish staging for esthesioneuroblastoma: Stage A — tumor confined to the nasal cavity only; Stage B — tumor involving nasal cavity and paranasal sinuses; Stage C — tumor extending beyond nasal cavity and paranasal sinuses to include the orbit, skull base, intracranial extension, cervical lymph nodes, or distant sites. Some authors add Stage D for distant metastasis. Stage C has 5-year survival around 40–50% versus 80–90% for stage A. Treatment is combined craniofacial resection (now often endoscopic skull base surgery + craniotomy for intracranial extension) plus post-operative radiotherapy. Cervical node metastasis occurs in ~20% at presentation.

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

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Written and medically reviewed by the StethoPrep medical team.