嗅神經母細胞（esthesioneuroblastoma, ENB）是在 1924 年首先由 Berger 等人描述的嗅 粘膜的一種罕見的侵襲性腫瘤。傳統上 ENB 可以透過根治性手術，放射治療和化療來治療。然 而，這種罕見的腫瘤具有高復發和死亡率，根據研究顯示，與單一形式治療相比，手術後合併放 射治療可提供更長的總生存期。因此本篇案例報告提出使用弧形調控放射治療技術（volumetric modulated arc therapy, VMAT）RapidArc 成功治療 ENB 的案例。 一名 72 歲的男性患者主訴，在 10 年期間鼻腔偶爾會有一些黃紅色的分泌物。最近 1 個月， 有咳嗽、鼻塞、嗅覺喪失和膿性鼻漏的症狀。2013 年 3 月 4 日 MRI 顯示，於右顱前窩發現有一 48 x 40 x 44 mm 硬膜外腫瘤並侵犯到右篩竇，頸部淋巴結無顯著腫大。病人被診斷為 Kadish 分 期 C，Hyams 分級 Ⅲ 的 ENB。使用 RapidArc 治療 7000 cGy 的累積劑量後，追蹤 39 個月患 者仍無病存活。

Esthesioneuroblastoma (ENB) is a rare aggressive tumor of the olfactory mucosa which was first described by Berger et al. in 1924. ENB has been traditionally treated with radical surgery, radiotherapy and/or chemotherapy. Nevertheless, these rare tumors are still associated with high rates of tumor recurrence and mortality. Studies have shown that surgery with postoperative radiotherapy offers a longer overall survival when compared with single modality treatment. We present an advanced case of ENB who was successfully treated with RapidArc (VMAT) technique. A 72 year-old male Taiwanese farmer was seen at the ENT outpatient clinic complaining of productive cough, nasal obstruction, loss of smell sensation and purulent rhinorrhea for 1 month, the patient also complained of yellow to reddish nasal discharge for 10 years. MRI on 2013/03/04 revealed a strongly enhanced right anterior cranial fossa epidural mass (48 x 40 x 44 mm) with a cystic component invading the right ethmoid sinus. No significant neck lymphadenopathy was noted. The patient was diagnosed as Kadish stage C, Hyams grade III ENB. Treatment consisted of giving a cumulative dose of 7000 cGy using the RapidArc technique concurrently with cisplatin and etoposide. The patient is still disease-free 39 months after CCRT.