1. MedPix Medical Image Database COW - Case of the Week Case Contributor: Steven J Goldstein Affiliation: University of Kentucky

2. MedPix No: 13705 - History Pt Demographics: Age = 38 y.o. Gender = woman 38 year old woman with 1 to 2 year history of intermittent epistaxis. This evaluation is for symptoms of nasal obstruction and imaging was done. Downloaded by (-1)

3. MedPix No: 13705 - EXAM & LABS Nasal mass visible on right.

4. Esthesioneuroblastoma (Olfactory neuroblastoma) Enhancing right-sided nasal mass with extension into the anterior cranial fossa via the cribiform plate. Downloaded by (-1)

5. Esthesioneuroblastoma (Olfactory neuroblastoma) Enhancing right-sided nasal mass with extension into the anterior cranial fossa via the cribiform plate. Downloaded by (-1)

6. Esthesioneuroblastoma (Olfactory neuroblastoma) Enhancing right-sided nasal mass with extension into the anterior cranial fossa via the cribiform plate. There is extensive sinus disease involving both maxillary and the sphenoid sinus. Downloaded by (-1)

7. Esthesioneuroblastoma (Olfactory neuroblastoma) Enhancing right-sided nasal mass with extension into the anterior cranial fossa via the cribiform plate. There is extensive sinus disease involving both maxillary and the sphenoid sinus. Downloaded by (-1)

8. Esthesioneuroblastoma (Olfactory neuroblastoma) Enhancing right-sided nasal mass with extension into the anterior cranial fossa via the cribiform plate. Downloaded by (-1)

9. Esthesioneuroblastoma (Olfactory neuroblastoma) Enhancing right-sided nasal mass with extension into the anterior cranial fossa via the cribiform plate. There is extensive sinus disease involving the sphenoid sinus - with enhancing and thickened mucosa. Downloaded by (-1)

10. Esthesioneuroblastoma (Olfactory neuroblastoma) Enhancing right-sided nasal mass with extension into the anterior cranial fossa via the cribiform plate. There is extensive sinus disease involving both maxillary and the sphenoid sinus. Downloaded by (-1)

11. Esthesioneuroblastoma (Olfactory neuroblastoma) Enhancing right-sided nasal mass with extension into the anterior cranial fossa via the cribiform plate. Downloaded by (-1)

12. Esthesioneuroblastoma (Olfactory neuroblastoma) Enhancing right-sided nasal mass with extension into the anterior cranial fossa via the cribiform plate. Downloaded by (-1)

13. Esthesioneuroblastoma (Olfactory neuroblastoma) Enhancing right-sided nasal mass with extension into the anterior cranial fossa via the cribiform plate. Downloaded by (-1)

14. Esthesioneuroblastoma (Olfactory neuroblastoma) Enhancing right-sided nasal mass with extension into the anterior cranial fossa via the cribiform plate. There is extensive sinus disease involving both maxillary and the sphenoid sinus. Downloaded by (-1)

15. FINDINGS Enhancing right-sided nasal mass eroding into the cribiform fossa. There are associated changes of both acute and chronic sinusitis.

16. DIFFERENTIAL DIAGNOSIS What is your Differential Diagnosis? Nasal polyps - Squamous cell carcinoma - Inverting papilloma - Esthesioneurblastoma - Neuroendocrine tumor

17. Diagnosis: Esthesioneuroblastoma Dx Confirmed by: Surgical resection and pathological examination

18. DISCUSSION