DOI: 10.36347/sjmcr.2024.v12i04.042

Pages: 552-556

This comprehensive case report presents a 65-year-old male with olfactory neuroblastoma, notable for its rarity and diagnostic challenges. The patient's clinical history includes significant smoking, alcohol consumption, and comorbidities. The initial presentation involved nasal obstruction, pain, and recurrent epistaxis, leading to a detailed imaging assessment revealing an extensive and infiltrative tumor. The biopsy confirmed grade II olfactory neuroblastoma. A thorough multidisciplinary discussion guided the treatment strategy, involving neoadjuvant chemotherapy with CISPLATIN and ETOPOSIDE. Remarkably, the patient exhibited a 30% reduction in tumor volume after three cycles, setting the stage for surgical intervention. The subsequent surgical excision revealed a high-grade tumor invading multiple structures, emphasizing the aggressive nature of olfactory neuroblastoma. Postoperative radiotherapy, intended for the positive margins and involved lymph nodes, was implemented, accompanied by manageable toxicities. The case highlights the intricate decision-making process in managing olfactory neuroblastoma, considering tumor extent, grade, and therapeutic response. In conclusion, this case underscores the need for a personalized and multidisciplinary approach to olfactory neuroblastoma, integrating chemotherapy, surgery, and radiotherapy. Despite the absence of established guidelines, the case offers insights into therapeutic decision-making, emphasizing the importance of ongoing clinical and imaging monitoring for optimal long-term outcomes.