Esthesioneuroblastoma with bilateral metastases to the parotid glands

Background Esthesioneuroblastoma (ENB) is a rare, poorly characterized, intranasal cancer arising from olfactory neuroepithelium. Methods This case report reviews the underlying pathophysiology, clinical presentation, and diagnosis of primary ENB and parotid metastases. Results We present the case of a 43-year-old man who was referred to our practice with radiographically and biopsy confirmed ENB. After neoadjuvant chemotherapy, radiation, and open surgical resection, he returned to the clinic 30 months postoperatively with a right parotid mass, which was found to be a recurrence of his primary cancer. A parotidectomy was performed; however, he returned 10 months later with a new left parotid mass. Subsequent imaging and biopsy confirmed recurrence of ENB and a second parotidectomy was performed. Conclusion This case illustrates that delayed metastases in the setting of ENB are not limited to the cervical lymph nodes and, in rare instances, may involve the parotid glands. Surveillance should include the parotid lymph node basin with a high clinical index of suspicion in the setting of parotid lymphadenopathy after primary surgical therapy. © 2016 Wiley Periodicals, Inc. Head Neck, 2016