Esthesioneuroblastoma: A Rare and Aggressive Sinonasal Tumor – Case Series and Review of the Literature

Esthesioneuroblastoma (ENB), also known as olfactory neuroblastoma, is a rare malignant neuroepithelial tumour of the nasal cavity. Its presentation is often non-specific, dominated by nasal obstruction, epistaxis or hyposmia, sometimes associated with ophthalmological or neurological signs, which explains why diagnosis is often delayed. Histologically, it is a proliferation of small, undifferentiated round cells, confirmed by immunohistochemistry. The most commonly used classification system for staging is the Kadish classification. This tumour is locally aggressive and characterised by a high risk of recurrence, sometimes late. The standard treatment is complete surgical excision followed by radiotherapy, while the role of chemotherapy remains controversial. Recent advances in radiotherapy and the adoption of endoscopic approaches offer hope for better local control with reduced morbidity. However, the prognosis remains uncertain, highlighting the importance of early diagnosis, prolonged follow-up and multidisciplinary management in specialised centres.