Retropharyngeal Lymph Node Metastasis From Esthesioneuroblastoma: A Review of the Therapeutic and Prognostic Implications

SUMMARY: Esthesioneuroblastoma (ENB) is a malignant neoplasm of the olfactory epithelium. Me-tastasis of ENBs to retropharyngeal lymph nodes is an important finding on imaging examinations that alters staging and treatment. A total of 17 cases of ENB from 3 institutions were evaluated. The CT and MR imaging findings from the cases of 4 patients with ENB with retropharyngeal metastatic disease are reviewed. The vector of spread, staging, and treatment implications are discussed. An esthesioneuroblastoma (ENB), also called an olfactoryneuroblastoma, is a rare neuroendocrine malignant neo-plasm of neural crest origin. The neoplasm almost invariably originates from the olfactory epithelium high within the nasal cavity. This highly vascular and resilient tumor has a known metastatic propensity to cervical lymph nodes and distantly to the thorax and skeleton.1 The incidence of cervical lymph node metastasis from a primary ENB has been reported to range from10 % to 44 % in the literature.2 Only 2 other cases of retropharyngeal lymph node (RPLN)metastasis have been re-ported in the literature to date.