A patient presents with unilateral nasal obstruction and recurrent epistaxis. MRI shows a mass in the superior nasal cavity extending through the cribriform plate into the anterior cranial fossa. Biopsy shows small round blue cells with rosette formation. What is the most likely diagnosis?

• A Sinonasal undifferentiated carcinoma
• B Adenoid cystic carcinoma
• C Extranodal NK/T-cell lymphoma
• D Esthesioneuroblastoma (olfactory neuroblastoma) ✓

Explanation

Esthesioneuroblastoma (olfactory neuroblastoma) arises from the olfactory epithelium in the superior nasal cavity. It characteristically presents with unilateral nasal obstruction and epistaxis, extends through the cribriform plate into the anterior cranial fossa, and shows small round blue cells with Homer Wright rosettes on histology. It is staged using the Kadish system. Unlike sinonasal lymphoma, it originates from the olfactory groove region and has a better prognosis with multimodality treatment.

Reference: Robbins and Cotran Pathologic Basis of Disease, 10th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.