INTRODUCTION: Esthesioneuroblastoma (ENB) is a rare, slow growing malignant tumor of neural crest origin comprising less than 5% of sinonasal malignancies. Since 1924, approximately 1400 cases have been reported affecting people mainly in their 2nd and 5-6th decades of life. Classically, the presentation is related to its site of origin and extent of invasion. The most common presenting symptoms are obstructed nasal breathing, rhinorrhea, and epistaxis. Headache and diplopia have also been reported with extension of the tumor into the skull base. ENB’s are thought to arise from the basal layer of olfactory epithelium with reports of ectopic ENB’s located in areas lacking normal olfactory neuro-epithelium. Due to the rarity of this malignancy and its local, slow growing nature, metastatic disease is not recognized as a common presentation.