Esthesioneuroblastoma staging

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Simrat Sarai, M.D. [2]

Overview

According to a staging system by Kadish, there are four stages of esthesioneuroblastoma based upon the extent of the primary tumor and lymph node or distant metastases. In 1992, Dulguerov and Calceterra proposed a classification based on the tumor, node, metastasis (TNM) system, predicted on CT and MRI findings that can be identified before treatment.^[1]^[2]^[3]

Staging

The most widely used approach is the Kadish clinical staging system. Kadish et al were the first to propose a staging classification for esthesioneuroblastoma (ENB). Esthesioneuroblastomas were divided into three categories: groups A, B, and C.
Group A is limited to tumors of the nasal fossa.
Group B, extension is to the paranasal sinuses.
Group C is defined as extension beyond the paranasal sinuses and nasal cavity.^[1]
In 1993, Morita et al published a revised Kadish system that redefined stage C (consisting of local disease spreading beyond the paranasal sinuses) and included a stage D (distant metastasis).^[2]
In 1992, Dulguerov and Calceterra proposed a classification based on the tumor, node, metastasis (TNM) system, which is predicted on CT and MRI findings that can be identified before treatment.^[3]

Kadish staging of Esthesioneuroblastoma


Stage	Features

Stage A	Tumor is limited to the nasal cavity
Stage B	Tumor is limited to the nasal cavity and paranasal sinuses
Stage C	Extension beyond the nasal cavity and paranasal sinuses
Stage D	Regional lymph node or distant metastasis

T Categories of esthesioneuroblastoma


T Classification	Thickness

T1	Tumor involvong the nasal cavity and/or paranasal sinuses (excluding sphenoid), sparing the most superior ethmoid cells
T2	Tumor involving the nasal cavity and/or paranasal sinuses (including the sphenoid), with extention to or erosion of the cribiform plate
T3	Tumor extending into the orbit or protruding into the anterior cranial fossa, without dural invasion
T4	Tumor involving the brain

N Categories of Esthesioneuroblastoma


N Lymph Node	Features

N0	No cervical lymph node metastasis
N1	Any form of cervical lymph node metastases

M Categories of Esthesioneuroblastoma


N Lymph Node	Features

M0	No metastasis
M1	Distant Metastases

References

↑ ^1.0 ^1.1 Kadish S, Goodman M, Wang CC (1976). “Olfactory neuroblastoma. A clinical analysis of 17 cases”. Cancer. 37 (3): 1571–6. PMID 1260676.
↑ ^2.0 ^2.1 Morita A, Ebersold MJ, Olsen KD, Foote RL, Lewis JE, Quast LM (1993). “Esthesioneuroblastoma: prognosis and management”. Neurosurgery. 32 (5): 706–14, discussion 714-5. PMID 8492845.
↑ ^3.0 ^3.1 Dulguerov P, Calcaterra T (1992). “Esthesioneuroblastoma: the UCLA experience 1970-1990”. Laryngoscope. 102 (8): 843–9. PMID 1495347.

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[pmid1260676-1] 1.0 ^1.1 Kadish S, Goodman M, Wang CC (1976). “Olfactory neuroblastoma. A clinical analysis of 17 cases”. Cancer. 37 (3): 1571–6. PMID 1260676.

[pmid8492845-2] 2.0 ^2.1 Morita A, Ebersold MJ, Olsen KD, Foote RL, Lewis JE, Quast LM (1993). “Esthesioneuroblastoma: prognosis and management”. Neurosurgery. 32 (5): 706–14, discussion 714-5. PMID 8492845.

[pmid1495347-3] 3.0 ^3.1 Dulguerov P, Calcaterra T (1992). “Esthesioneuroblastoma: the UCLA experience 1970-1990”. Laryngoscope. 102 (8): 843–9. PMID 1495347.

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