Delayed Isolated Metastatic Neck Disease in Olfactory Neuroblastoma with No Recurrence of Primary.

Introduction: Olfactory neuroblastoma is a rare sinonasal tumor with high potential for local recurrence. It arises from the olfactory neuroepithelium. Case Report: We present a 55-year-old man who was previously diagnosed with an olfactory neuroblastoma and had undergone endoscopic excision of the tumor followed by radiotherapy. He was well until nine months post-treatment, when he presented with a three-month history of left-sided neck swelling. Neck examination revealed left submandibular lymphadenopathy. Nasoendoscopy showed no recurrence. Fine needle aspiration cytology (FNAC) confirmed it to be a metastatic olfactory neuroblastoma. Computed tomography (CT) showed radioimaging evidence of mild enhancement within the ethmoid sinuses and left submandibular lymph node suggestive of metastasis. Positron Emission Tomography (PET) scan demonstrated high uptake at level I and level II neck nodes with no uptake at the previous primary site. He subsequently underwent bilateral modified radical neck dissection. Conclusion: Multimodality imaging and clinical examination are important in identifying recurrence of disease before proceeding with its management, especially for tumors with a high risk of local recurrence which includes olfactory neuroblastoma. [ABSTRACT FROM AUTHOR]