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2.1
Nasopharyngeal Neoplasm
Tumour of the Nasopharynx

Presentation

Seven patients (six males and one female) with radiation-associated temporal bone tumours are presented (five squamous cell carcinomas, one osteogenic sarcoma and one chondrosarcoma). [ncbi.nlm.nih.gov]

Case Presentation We present a 24 year old Asian female student presented with acute diminution of vision in both eyes 4 years back followed by complete loss of vision one year later in both eyes. [npplweb.com]

In North America, around 25% of patients present kind I, 12% presents kind II and 63% present kind III(4). [arquivosdeorl.org.br]

Unilateral cervical lymphadenopathy was present in 4 (36%) and bilateral in 7 (64%). Lateral retropharyngeal lymphadenopathy that measured greater than 1 cm in maximal transverse dimension was present in 10 (91%). [ajnr.org]

Log In or Register to continue Aug 24, 2017 | Posted by in OTOLARYNGOLOGY | Comments Off on Large nasopharyngeal inverted papilloma presenting with rustling tinnitus [entokey.com]

Immune System

  • Cervical Lymphadenopathy

    The incidence of distant metastasis was related to the stage of the cervical lymphadenopathy: 16% in patients with N0-N1 nodes compared with 40% in the N2-3 node group. [ncbi.nlm.nih.gov]

    Other symptoms include ear pain, purulent bloody rhinorrhea, frank epistaxis, cranial nerve palsies, and cervical lymphadenopathy. [merckmanuals.com]

    In addition, all of our patients also had cervical lymphadenopathy. [ajnr.org]

    Common presentations The following are some ways in which NPC can present in patients: Neck lump (Cervical lymphadenopathy), usually upper neck in levels II and Va. [singhealth.com.sg]

    lymphadenopathy secondary to lymph node metastasis or obstructive symptoms related to nasopharyngeal mass, e.g. postnasal drip, nasal discharge, epistaxis, serous otitis media and tinnitus Headache and symptoms of cranial nerve involvement in advanced [pathologyoutlines.com]

Entire Body System

  • Lymphadenopathy

    RMJ. 2014; 39(4): 446-448 Neck lymphadenopathy as the only clue to nasopharyngeal carcinoma Pir Bux Magsi, Bahawal Uddin Jamro, Hamid Ali Sangi. [scopemed.org]

    In addition, all of our patients also had cervical lymphadenopathy. [ajnr.org]

    The corresponding failure rate in the neck was 18% for N0, 14% for N1, and 33% for N2 and N3 lymphadenopathy. [ncbi.nlm.nih.gov]

    Other symptoms include ear pain, purulent bloody rhinorrhea, frank epistaxis, cranial nerve palsies, and cervical lymphadenopathy. [merckmanuals.com]

    Approximately 90% of patients develop lymphadenopathy, which is present in more than 70% at initial diagnosis ( 21 ). [oncohemakey.com]

  • Hodgkin Lymphoma

    / HODGKIN LYMPHOMA 86 LINFOMA NON-HODGKIN/ NON-HODGKIN LYMPHOMA 87 LEUCEMIA LINFATICA CRONICA, LINFOMA A PICCOLI LINFOCITI B/ CHRONIC LYMPHOCYTIC LEUKAEMIA, SMALL LYMPHOCYTIC LYMPHOMA 88 LINFOMA DIFFUSO A GRANDI CELLULE B/ DIFFUSE LARGE B-CELL LYMPHOMA [epiprev.it]

    See Non-Hodgkin Lymphoma to learn more. Adenocarcinoma and adenoid cystic carcinoma are cancers that can start in the minor salivary glands in the nasopharynx. [cancer.org]

    In our study, 80% of the malign tumors were carcinomas, one case of non-Hodgkin lymphoma and one undifferentiated neoplasia. [arquivosdeorl.org.br]

    Thus, diseases such as thyroid cancer, rhabdomyosarcoma, non-Hodgkin lymphoma including Burkitt lymphoma, and Hodgkin lymphoma must be considered, as well as benign conditions such as nasal angiofibroma, which usually presents with epistaxis in adolescent [northshore.org]

    […] lesion identified only on microscopy Microscopic (histologic) description Either syncytial arrangement of cohesive cells with indistinct cell margins (Regaud pattern) or diffuse cellular infiltrate of noncohesive cells (Schmincke pattern) resembling non-Hodgkin [pathologyoutlines.com]

Gastrointestinal

  • Diarrhea

    My mom had diarrhea the day after treatment. She also had a little nausea. She will get another treatment in 2 days. They will give it to her every week. She also takes decadron before each Chemo. [cancercompass.com]

    There are effective and readily available medications to address traditional side effects from cancer treatment (such as nausea, diarrhea, constipation and mouth sores.) [cancersupportcommunity.org]

    Avoid with diarrhea or high or low blood pressure. Avoid taking pomegranate fruit husk with oil or fats to treat parasites. Pomegranate root/stem bark should only be used under the supervision of a qualified healthcare professional. [livingnaturally.com]

Jaw & Teeth

  • Halitosis

    Other symptoms include bleeding causing haemoptysis, halitosis, trismus (suggests involvement of the pterygoid muscles) and weight loss. See the separate articles on Problems in the Mouth, Oral Ulceration and Salivary Gland Disorders. [patient.info]

Ears

  • Otalgia

    Audiological symptoms like tinnitus, otalgia and deafness: These are common symptoms of nasopharyngeal malignancy. This is caused by blockage to the nasopharyngeal end of eustachean tube by the tumor mass. 9. [drtbalu.com]

    We found the following prevalence of symptoms and signs in descending order in patients with malign neoplasias: nasal obstruction (6), epistaxis (4), rhinorrhea (4), cervical lymphonodomegalia (4), otalgia (4), hypoacusis (3), cephalgia (3), cervicalgia [arquivosdeorl.org.br]

    Otalgia. Otitis media. Given the rich lymphatic drainage of the nasopharynx, bilateral cervical lymphadenopathy is often the first sign of disease. [northshore.org]

Face, Head & Neck

  • Epistaxis

    The most common symptoms were nasal obstruction (100%), epistaxis (75%) and rhinorrhea (50%), findings which agree on the nasoangiofibroma literatur(2). [arquivosdeorl.org.br]

    Clinical presentation includes epistaxis and conductive hearing loss. [radiopaedia.org]

    […] and Nasorespiratory Symptoms • blood stained nasal discharge • blood stained saliva on hawking • profuse epistaxis • nasal obstruction • ozanea due to tumor necrosis 26. 26 Neurological Palsies • Most frequently involved are:  VI - Lateral rectus palsy [slideshare.net]

    Other symptoms include ear pain, purulent bloody rhinorrhea, frank epistaxis, cranial nerve palsies, and cervical lymphadenopathy. [merckmanuals.com]

    Exclusion Criteria: Presence of local recurrence Presence of neck lymph node recurrence invading vascular structure; Presence of central lung lesions involving major blood vessels; History of hemoptysis or epistaxis within 4 weeks; Preexisting uncontrolled [clinicaltrials.gov]

  • Neck Mass

    Open cervical node biopsy should not be done as the initial procedure (see Neck Mass ), although a needle biopsy is acceptable and often recommended. [merckmanuals.com]

    Investigations [ 17 ] Diagnosis is made by biopsy of the nasopharyngeal mass. FNA of a neck mass may be useful for the detection of an occult nasopharyngeal primary tumour. [patient.info]

    (Tham IW, Head Neck. 2009 Feb 2. [Epub ahead of print]) Retrospective. 667 patients, NPC, Stage T2-4 N0-1. RLN+ in 47% by CT. [en.wikibooks.org]

    FNA of a neck mass (Diff-Quik) Negative stains CK7, CK20 Other negative stains (may be useful to rule out mimics): CD45, S100, HMB45, MelanA, desmin, myoglobin, myogenin Rarely positive for CK7 Electron microscopy images Images hosted on other servers [pathologyoutlines.com]

    Although a neck mass elicits medical attention in only 18% to 66% of cases, clinical involvement of cervical lymph nodes on examination at presentation ranges from 60% to 87% ( 11, 19 ). Some patients present with cranial nerve involvement. [oncohemakey.com]

  • Facial Pain

    Grade 3-5 investigator-assessed, treatment-related adverse events were hepatitis (n = 2); pneumonitis (n = 2); anemia (n = 1); facial pain (n = 1); increased blood creatine phosphokinase (n = 1); proteinuria (n = 1); and sepsis (n = 1). [ascopost.com]

    pain); 4- cervical adenomegalies. [arquivosdeorl.org.br]

    Sore throat : Oropharyngeal extension Pain : Compression of Vth cranial nerve ( facial pain) Trismus : Mandibular nerve involvement or pterygoid muscle invasion. 11. Cranial Nerve involvement 12. [slideshare.net]

Neurologic

  • Cranial Nerve Involvement

    Some patients present with cranial nerve involvement. In 218 patients, 26% had cranial nerve involvement, although it caused presenting symptoms in only 3% ( 19 ). [oncohemakey.com]

    Multivariate analysis showed that tumor stage and histological type, cranial nerve involvement, patient age, and doses of irradiation to the nasopharynx were significant prognostic factors for local/regional tumor control. [ncbi.nlm.nih.gov]

    […] hearing loss from serous otitis media or recurrent acute otitis media • advanced cases - cranial nerve involvement (III-VI), including diplopia and numbness of the face 21. 21 • neck lump - 60% • block sensation of ear - 41% • hearing loss - 37% • nasal [slideshare.net]

    nerve involvement in advanced disease with skull base involvement Laboratory Positive Epstein-Barr virus (EBV) serology Elevated circulating EBV DNA or RNA, e.g. plasma or serum EBV encoded small RNA (EBERs) Radiology images Images hosted on other servers [pathologyoutlines.com]

  • Seizure

    Avoid with a history of seizures, bleeding disorders, eating disorders (such as anorexia or bulimia), or anemia (low levels of iron). Avoid if pregnant or breastfeeding. [livingnaturally.com]

  • Irritability

    Use cautiously with gastrointestinal irritation or peptic ulcer disease due to anecdotal reports of gastrointestinal irritation. [livingnaturally.com]

Workup

DIAGNOSTIC WORKUP A complete history and physical examination includes detailed evaluation of extent of disease in the pharynx ( Table 14-2 ). Extent of neck node metastases must be assessed, and a search made for distant metastases. [oncohemakey.com]

Workup includes: Careful visual examination (by mirror or endoscope), evaluation of neck nodes, evaluation of cranial nerve function and hearing. Skull X-rays (especially base-of-skull views) to evaluate neural foramina. CXR. [patient.info]

Treatment

Two patients died from the disease within three months of treatment with one patient surviving 36 months at the time of writing. One patient died from an unrelated medical condition three months after surgery. [ncbi.nlm.nih.gov]

Treatment innovations with molecularly targeted therapies and immunotherapy are being assessed to improve treatment outcomes in NPC and will impact oral complications and oral care. [scholars.northwestern.edu]

[…] down the treatment process. [saintpetershcs.com]

On the whole, the tolerance of the treatment was good (chemotherapy 71%, radiotherapy 82%). Treatment mortality was null. The BAC regime was the most effective. At the end of the treatment, a total response was obtained in 82% of cases. [ssl.elidee.com]

You will still receive the best standard treatment available. [macmillan.org.uk]

Prognosis

If you have nasopharyngeal cancer, you may have questions about your prognosis. A prognosis is the doctor’s best estimate of how cancer will affect someone and how it will respond to treatment. Prognosis and survival depend on many factors. [cancer.ca]

In order to support cancer therapy the dental provider must be aware of the diagnosis, prognosis and approach to treatment. [scholars.northwestern.edu]

As such, PD-1 and PD-L1 expression might correlate with poor prognosis in patients with nasopharyngeal carcinoma. [onclive.com]

Retropharyngeal lymph nodes [ edit ] It is not clear whether these are staged as N0 or N1, with differences among institutions Prognosis for RLN+ N0 appears comparable to N1 RLNs atrophy with age, and are usually obliterated by adulthood. [en.wikibooks.org]

The depth of infiltration is predictive of prognosis. T - Primary tumour Oropharynx: TX - primary tumour cannot be assessed. T0 - no evidence of primary tumour. Tis - pre-invasive cancer (carcinoma in situ). [patient.info]

Etiology

Etiology and general considerations of radiating implants are discussed. [semanticscholar.org]

Epidemiological and etiological factors associated with nasopharyngeal carcinoma. [npplweb.com]

To investigate genetic, dietary, occupational, and behavioral factors related to the etiology of NPC, several studies were conducted in including a case-control study of approximately 1,000 individuals and a multiplex family study of approximately 3,000 [grantome.com]

Etiology NPC is the commonest epithelial cancer in adults. [ojrd.biomedcentral.com]

Over several generations, the prevalence among Chinese-Americans gradually decreases to that among non-Chinese Americans, suggesting an environmental component to etiology. [merckmanuals.com]

Epidemiology

An epidemiologic and clinical study of nasopharyngeal carcinoma. International journal of radiation oncology, biology, physics. Mar-Apr 1978;4(3-4):182-198. [headandneckcancerguide.org]

Int J Cancer 85(3): 364–369 CrossRef PubMed Google Scholar Yu MC (1991) Nasopharyngeal carcinoma: epidemiology and dietary factors. [link.springer.com]

"The Enigmatic Epidemiology of Nasopharyngeal Carcinoma". Cancer Epidemiology, Biomarkers & Prevention. 15 (10): 1765–1777. doi : 10.1158/1055-9965.EPI-06-0353. PMID 17035381. ^ Li, Yvonne Y.; Chung, Grace T. Y.; Lui, Vivian W. [en.wikipedia.org]

Each entity is extensively discussed with information on clinicopathological, epidemiological, immunophenotypic and genetic aspects of these diseases. This book is in the series commonly referred to as the "Blue Book" series. Contributors: :Dr. [books.google.com]

Epidemiology Frequency United States Although the incidence varies according to geographic location, approximately 1 in every 100,000 children are diagnosed annually in North America. [emedicine.medscape.com]

Pathophysiology

Pathophysiology The detection of the Epstein-Barr virus (EBV) nuclear antigen and viral DNA in nasopharyngeal carcinoma has revealed that EBV can infect epithelial cells and is associated with their malignant transformation. [1] Copies of the EBV genome [emedicine.medscape.com]

Prevention

Causes, Risk Factors, and Prevention Learn about the risk factors for nasopharyngeal cancer and what you might be able to do to help lower your risk. Early Detection, Diagnosis, and Staging Know the signs and symptoms of nasopharyngeal cancer. [cancer.org]

Cancer epidemiology, biomarkers & prevention: a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology. [headandneckcancerguide.org]

Prevention No sure way exists to prevent nasopharyngeal carcinoma. However, if you're concerned about your risk of nasopharyngeal carcinoma, you may consider avoiding habits that have been associated with the disease. [mayoclinic.org]

Tea tree oil : Tea tree oil is purported to have antiseptic properties, and has been used traditionally to prevent and treat infections. [livingnaturally.com]

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