nasopharyngeal cancer

nasopharyngeal cancer

a malignant neoplastic disease of the nasopharynx. Depending on the site of a nasopharyngeal tumor, there may be nasal obstruction, otitis media, hearing loss, sensory or motor nerve damage, bony destruction of the skull, or deep cervical lymphadenopathy. Diagnostic measures include nasopharyngoscopy, biopsy, and radiological examination of the skull with tomographic studies. Squamous cell and undifferentiated carcinomas are the most common lesions. Nasopharyngeal cancer occurs rarely in the United States and frequently in southern China. Exposure to dusts of nickel, chromium, wood, and leather and to isopropyl oil increases the risk of developing nasopharyngeal cancer. High titers of antibodies to the Epstein-Barr virus are found in Chinese patients with the cancer, and there is evidence of genetic susceptibility, because a certain histocompatibility antigen is associated with the disease and multiple cases occur in some families. Radiation is the most effective therapy, and chemotherapy is also used.

nasopharyngeal carcinoma

A rare (in the West) malignancy which is endemic in regions of southern China—where it comprises up to 18% of cancers—as well as in southeast Asia. It is linked to EBV infection, diets high in nitrosamines and inhaled carcinogens. It is more common in males and has a peak incidence of age 40 to 50.

DiffDx
Lymphoma (DLCBL, Hodgkin's), reactive lymphoid proliferation, sarcomas.

Management
Radiotherapy, chemotherapy.

Prognosis
Stage dependant; 5-year survival is 55%.

Nasopharyngeal carcinomas (WHO, 2005)
- Keratinising squamous cell carcinoma
- Non keratinsing carcinoma
  • Differentiated
  • Undifferentiated
- Basaloid squamous cell carcinoma
- Nasopharyngeal cancer, staging
  • Stage I—Lesion confined to nasopharynx.
  • Stage II
    A) Lesion extends to oropharynx and/or nasal fossa.
    B) Lesion extends to nearby lymph nodes or to parapharyngeal region.
  • Stage III—Lesion spread to lymph nodes on both sides of the neck or nearby bones or sinuses.
  • Stage IV
    A) Spread beyond nasopharynx to other areas in head; possible spread to regional lymph nodes.
    B) Spread beyond nasopharynx to other areas in head and to lymph nodes above clavicle, or are ≥ 6 cm in greatest dimension.
    C) Metastasised.

nasopharyngeal carcinoma

Nasopharyngeal cancer A rare malignancy, which is endemic to regions of southern China and Southeast Asia; persons with serologic markers for EBV–IgA antibodies against EBV capsid antigen and/or neutralizing antibodies against EBV-specific DNase have a 3-fold cumulative risk of nasopharyngeal cancer if one marker was positive and a 35-fold risk if both markers are positive. See Epstein-Barr virus.

Nasopharyngeal cancer

Stage I Lesion confined to nasopharynx

Stage II

A  Lesion extends to oropharynx and/or nasal fossa

B  Lesion extends to nearby lymph nodes or to parapharyngeal region

Stage III Lesion spread to lymph nodes on both sides of the neck or to nearby bones or sinuses

Stage IV

A Spread beyond nasopharynx to other areas in head, and  possibly to nearby lymph nodes

B Spread beyond nasopharynx to other areas in head and to lymph nodes above clavicle or are ≥ 6 cm

C Lesion has metastasized