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The differential diagnosis is broad. It includes Olfactory neuroblastoma (ONB), Small cell undifferentiated NEC (ScNEC), Undifferentiated Nasopharyngeal carcinoma, Lymphoepithelial carcinoma, Rhabdomyosarcoma, PNET/Ewing’s sarcoma, SCC Keratinizing/non-keratinizing, and melanoma.
Some clinicians divide sinonasal tumors with neuroendocrine differentiation into ONB vs SNUC/ScNEC for treatment purposes (ONB treated locally, vs others treated systemically). Other authors advocate moving away from the conventional carcinoid/small cell terminology and adopting the well/moderately/poorly differentiated neuroendocrine carcinoma termiology (group 1 neuroectodermal differentiated tumors) and grouping these tumors separately from other neuroectodermal differentiated tumors such as ONB, Ewings, and melanoma (group 2)
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