Diagnostic tests

The following tests may be used to diagnose esthesioneuroblastoma:

Magnetic resonance imaging (MRI)

MRI uses a magnet, radio waves, and a computer to make a series of detailed pictures of areas of the body, such as the head and neck. This procedure is also called nuclear MRI (NMRI).

Magnetic resonance imaging (MRI) scan. The child lies on a table that slides into the MRI machine, which takes a series of detailed pictures of areas inside the body. The positioning of the child on the table depends on the part of the body being imaged.

CT scan (CAT scan)

CT scan uses a computer linked to an x-ray machine to make a series of detailed pictures of areas inside the body, such as the head and neck or lymph nodes. The pictures are taken from different angles and are used to create 3-D views of tissues and organs. A dye may be injected into a vein or swallowed to help the organs or tissues show up more clearly. This procedure is also called computed tomography, computerized tomography, or computerized axial tomography. Learn more about Computed Tomography (CT) Scans and Cancer.

Computed tomography (CT) scan of the head and neck. The child lies on a table that slides through the CT scanner, which takes a series of detailed x-ray pictures of the inside of the head and neck.

Tests to stage childhood esthesioneuroblastoma

If your child is diagnosed with esthesioneuroblastoma, they will be referred to a pediatric oncologist. This is a doctor who specializes in staging and treating esthesioneuroblastoma and other cancers. They will recommend tests to determine the extent (stage) of cancer. Sometimes the cancer is only in the olfactory nerve ending in the upper nasal cavity. Or, it may have spread from the nasal cavity to other parts of the body. The process of learning the extent of cancer in the body is called staging. It is important to know the stage of esthesioneuroblastoma to plan treatment.

Most children with esthesioneuroblastoma are at an advanced stage at the time of diagnosis. Esthesioneuroblastoma spreads most often to nearby tissue, including the olfactory bulb, nasal sinuses, or brain. It can also spread to the lymph nodes, lungs, liver, bone or bone marrow.

Learn more about a specific stage of esthesioneuroblastoma at Stages of childhood esthesioneuroblastoma.

The following tests may be used to determine the esthesioneuroblastoma stage:

Stage A esthesioneuroblastoma

In stage A, cancer is found in the nasal cavity only.

Stage B esthesioneuroblastoma

In stage B, cancer has spread from the nasal cavity to the nasal sinuses.

Stage C esthesioneuroblastoma

In stage C, cancer has spread through the nasal sinuses to nearby tissue.

Stage D esthesioneuroblastoma

In stage D, cancer has spread to distant parts of the body, such as the lymph nodes in the neck, or to the brain, bone marrow, or lung.

Who treats children with esthesioneuroblastoma?

A pediatric oncologist, a doctor who specializes in treating children with cancer, oversees treatment of esthesioneuroblastoma. The pediatric oncologist works with other health care providers who are experts in treating children with cancer and who specialize in certain areas of medicine. Other specialists may include:

• pediatrician
• pediatric surgeon
• radiation oncologist
• pathologist
• pediatric nurse specialist
• social worker
• rehabilitation specialist
• psychologist
• child-life specialist

There are different types of treatment for children and adolescents with esthesioneuroblastoma. You and your child's care team will work together to decide treatment. Many factors will be considered, such as your child's overall health and whether the cancer is newly diagnosed or has come back.

Your child's treatment plan will include information about the cancer, the goals of treatment, treatment options, and the possible side effects. It will be helpful to talk with your child's care team before treatment begins about what to expect. For help every step of the way, see our downloadable booklet, Children with Cancer: A Guide for Parents.

Surgery

Surgery to remove the tumor is one of the main treatments for esthesioneuroblastoma.

After the doctor removes all the cancer that can be seen at the time of the surgery, your child may be given chemotherapy or radiation therapy to kill any cancer cells that are left. Treatment given after surgery to lower the risk that the cancer will come back is called adjuvant therapy.

Radiation therapy

Radiation therapy uses high-energy x-rays or other types of radiation to kill cancer cells or keep them from growing. Esthesioneuroblastoma may be treated with external beam radiation therapy. This type of radiation therapy uses a machine outside the body to send radiation toward the area of the body with cancer. Radiation therapy may be given alone or with other treatments, such as chemotherapy.

Learn more about External Beam Radiation Therapy for Cancer and Radiation Therapy Side Effects.

Chemotherapy

Chemotherapy (also called chemo) uses drugs to stop the growth of cancer cells. Chemotherapy either kills the cells or stops them from dividing. Chemotherapy may be given alone or with other types of treatment, such as radiation therapy.

For esthesioneuroblastoma, the chemotherapy is injected into a vein. When given this way, the drugs enter the bloodstream and can reach cancer cells throughout the body.

Chemotherapy drugs used alone or in combination to treat esthesioneuroblastoma in children include:

• cisplatin
• cyclophosphamide
• dactinomycin
• docetaxel
• doxorubicin
• etoposide
• ifosfamide
• irinotecan
• vincristine

Other chemotherapy drugs not listed here may also be used.

Learn more about Chemotherapy to Treat Cancer.

Clinical trials

For some children, joining a clinical trial may be an option. There are different types of clinical trials for childhood cancer. For example, a treatment trial tests new treatments or new ways of using current treatments. Supportive care and palliative care trials look at ways to improve quality of life, especially for those who have side effects from cancer and its treatment.

You can use the clinical trial search to find NCI-supported cancer clinical trials accepting participants. The search allows you to filter trials based on the type of cancer, your child's age, and where the trials are being done. Clinical trials supported by other organizations can be found on the ClinicalTrials.gov website.

Learn more about clinical trials, including how to find and join one, at Clinical Trials Information for Patients and Caregivers.

Treatment of childhood esthesioneuroblastoma

Treatment of newly diagnosed stage A esthesioneuroblastoma may include:

• surgery to remove the tumor followed by radiation therapy if visible tumor cells remain after surgery

Treatment of newly diagnosed stage B esthesioneuroblastoma may include:

• surgery to remove the tumor followed by radiation therapy

Treatment of newly diagnosed stage C esthesioneuroblastoma may include:

• chemotherapy followed by surgery to remove the tumor
• radiation therapy followed by surgery to remove the tumor
• chemotherapy and radiation therapy given at the same time followed by surgery to remove the tumor

Treatment of newly diagnosed stage D esthesioneuroblastoma may include:

• chemotherapy given before or after surgery to remove the tumor
• radiation therapy to the tumor and other places in the body where the cancer has spread

If the cancer comes back after treatment, your child's doctor will talk with you about what to expect and possible next steps. There might be treatment options that may shrink the cancer or control its growth. If there are no treatments, your child can receive care to control symptoms from cancer so they can be as comfortable as possible.

Use our clinical trial search to find NCI-supported cancer clinical trials that are accepting patients. You can search for trials based on the type of cancer, the age of the patient, and where the trials are being done. General information about clinical trials is also available.

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A clinical trial is a study to answer a scientific question, such as whether one treatment is better than another. Trials are based on past studies and what has been learned in the laboratory. Each trial answers certain scientific questions in order to find new and better ways to help cancer patients. During treatment clinical trials, information is collected about the effects of a new treatment and how well it works. If a clinical trial shows that a new treatment is better than one currently being used, the new treatment may become "standard." Patients may want to think about taking part in a clinical trial. Some clinical trials are open only to patients who have not started treatment.

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