Figure 13.

Olfactory neuroblastoma. (A) Coronal CT image shows a soft tissue density lesion centered in the left greater-than-right superior nasal cavity with left intraorbital and anterior cranial fossa extension through erosion of the cribriform plate and lamina papyracea (red arrows). (B) T2W and (C) noncontrast T1W coronal images reveal a dumbbell-shaped mass with heterogeneous signal intensity extending into the superior nasal cavity, paranasal sinuses, anterior cranial fossa, and left orbit (red arrows). The ‘waist’ of the dumbbell is centered at the cribriform plate. The mass causes marked mass effect on the adjacent frontal lobes with vasogenic edema. Peritumoral cysts are also noted at the tumor–brain interface (black arrows). (D) Coronal postcontrast T1W image shows intense heterogeneous and irregular enhancement of the lesion with smooth wall enhancement of the several peritumoral cysts, while one shows no appreciable enhancement (blue arrow).