Olfactory neuroblastoma. Biologic and clinical behavior.

The biologic behavior of olfactory neuroblastoma in 21 persons treated at the Mayo Clinic, Rochester, Minn, from 1960 to 1980 is reviewed. Follow-up data of five years or more are available for 19 cases. Findings showed the tendency of these tumors to spread submucosally and intracranially without obvious involvement of the anterior cranial fossa dura. The aggressive nature of this lesion has not been appreciated. Metastatic disease occurred in 62% and local recurrence in 57%. Long-term follow-up showed that recurrent or metastatic disease could occur up to ten years after initial diagnosis. The five-year survival rate was 58%. Only four patients who have been follow-up for more than five years were without local recurrence or metastasis. This review should prompt a change in the current attitudes toward treatment of this tumor.