ABSTRACT
@#<p style="text-align: justify;">This is a case of a 47 year-old female presenting with typical Cushingoid appearance and CSF rhinorrhea. MRI revealed a 4.4 cm x 2.9 cm x 4.5 cm enhancing intranasal mass with evidence of erosion of the left cribriform extending to the left anterior cranial fossa. Dexamethasone suppression test yielded elevated cortisol level. Endoscopic nasal biopsy done showed a round cell tumor positive for ACTH, synaptophysin, chromogranin A, and S-100. Patient subsequently underwent endoscopic endonasal excision of left intranasal mass with creation of pericranial flap for repair of CSF leak. This report is presented to discuss a rare case of ACTH secreting esthesioneurblastoma including its diagnostic challenges and surgical options for repair of anterior cranial fossa defect to address CSF leak particularly by means of a vascularized pericranial flap.</p>