title: Esthesioneuroblastoma with bilateral metastases to the parotid glands.
abstract: 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.
  
  
  CONCLUSIONS
  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 38: E2457-E2460, 2016.
authors.affiliation: Saint Louis University School of Medicine, St. Louis, Missouri.
authors.forename: Adnan S
authors.initials: AS
authors.lastname: Hussaini
authors.affiliation: Department of Radiation Oncology, Saint Louis University School of Medicine, St. Louis, Missouri.
authors.forename: John J
authors.initials: JJ
authors.lastname: Dombrowski
authors.affiliation: Department of Pathology, Saint Louis University School of Medicine, St. Louis, Missouri.
authors.forename: E Stephen
authors.initials: ES
authors.lastname: Bolesta
authors.affiliation: Department of Otolaryngology - Head and Neck Surgery, Saint Louis University School of Medicine, St. Louis, Missouri.
authors.forename: Ronald J
authors.initials: RJ
authors.lastname: Walker
authors.affiliation: Department of Otology and Laryngology, Harvard Medical School and the Department of Otolaryngology, the Massachusetts Eye and Ear Infirmary, Boston, Massachusetts.
authors.forename: Mark A
authors.initials: MA
authors.lastname: Varvares
keywords: chemoradiation; craniofacial resection; esthesioneuroblastoma; olfactory neuroblastoma; parotid gland