Symptoms of Esthesioneuroblastoma

Esthesioneuroblastoma, also called olfactory neuroblastoma, is a rare cancer that begins in the upper part of the nasal cavity, near the nerves responsible for our sense of smell. This tumor can be difficult to detect early because its symptoms often resemble those of more common conditions like sinus infections or allergies.

However, recognizing the signs and symptoms of esthesioneuroblastoma is crucial for early diagnosis and effective treatment. This article will cover the most common symptoms, how they may present differently across patients, and why early detection can make a meaningful difference in the treatment process and outcomes.

One of the common early signs of esthesioneuroblastoma starts in the nasal passages. Since the tumor grows in the upper part of the nasal cavity, it often causes symptoms like those seen in sinusitis or other nasal conditions.

• Nasal Congestion: Persistent congestion, especially if it affects only one side of the nose, can be an early sign. Unlike typical nasal congestion from a cold, this symptom does not improve with standard treatments.
• Frequent Nosebleeds (Epistaxis): Recurrent nosebleeds can occur as the tumor irritates the delicate tissues inside the nasal cavity. This symptom should be assessed by a medical provider, particularly if there is no obvious cause for the bleeding.
• Loss of Smell (Anosmia): Because the tumor is near the olfactory nerves, it can disrupt the sense of smell. A gradual or sudden loss of smell is often one of the first symptoms.

As the tumor grows, it can put pressure on surrounding areas in the head and face, leading to pain or discomfort.

• Sinus Pressure: Blocking normal drainage in the nasal passages can cause pressure. This may lead to a feeling of fullness or discomfort, similar to a sinus infection.
• Headaches: Ongoing headaches, particularly those around the forehead, eyes, or upper nose, can be a sign of esthesioneuroblastoma. These headaches may feel more intense in the morning or when bending over.

Esthesioneuroblastoma can grow in a way that affects nearby structures, including the eyes, resulting in vision-related problems.

• Double Vision (Diplopia): The tumor may press on nerves controlling eye movement, leading to double vision. This can make it difficult for patients to focus on objects or cause visual distortions.
• Protrusion of the Eye (Proptosis): In some cases, the tumor can push the eye outward, a condition known as proptosis. This symptom is often a sign that the tumor has grown beyond the nasal cavity.

As esthesioneuroblastoma progresses, it may extend into the brain. This can lead to more severe symptoms that affect neurological function.

• Difficulty Breathing or Swallowing: A large tumor can obstruct the nasal passages, making it difficult for patients to breathe through their nose. In advanced cases, it may also cause difficulty swallowing.
• Changes in Mental Status: In rare cases where the tumor invades the brain, symptoms such as confusion, memory loss, or changes in personality can occur. These are more likely to appear in advanced stages and require immediate medical attention.

Esthesioneuroblastoma can spread to neck lymph nodes, causing noticeable swelling. This change, often found in physical exams, may indicate tumor metastasis and prompt further testing.

Though less common, esthesioneuroblastoma can sometimes affect the teeth and gums, leading to dental symptoms. If the tumor grows into the upper jaw, patients may experience tooth pain, loosened teeth, or discomfort in the roof of the mouth. Dental issues that do not resolve with routine treatment could be a sign of an underlying issue like a tumor.

Early detection of esthesioneuroblastoma greatly improves the chances of successful treatment. However, because symptoms often mimic more common conditions like allergies, sinusitis, or migraines, this tumor can be difficult to diagnose early.

If symptoms persist or seem unusual, especially when they don’t respond to typical treatments, should prompt further medical evaluation. To diagnose this condition accurately, doctors may use a combination of imaging studies, nasal endoscopy, and biopsy.

Addressing symptoms early not only helps with early diagnosis but also can provide better outcomes and potentially reduce the risk of recurrence after treatment.

• Nasal symptoms such as persistent congestion, nosebleeds, and loss of smell are common early signs of esthesioneuroblastoma.
• Facial pain, pressure, and vision changes may indicate that the tumor has grown beyond the nasal cavity.
• Neurological symptoms, neck swelling, and dental problems can be signs of advanced or spreading esthesioneuroblastoma.
• Early detection is crucial for improving the prognosis, and persistent or unusual symptoms should be evaluated by a healthcare provider.

• National Cancer Institute - Olfactory Neuroblastoma
• American Brain Tumor Association (ABTA)
• American Association of Neurological Surgeons (AANS) - Brain Tumors
• NCBI - StatPearls: Esthesioneuroblastoma