Advanced stage nasopharyngeal carcinoma in children (original) (raw)
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Pediatric advanced stage nasopharyngeal carcinoma - case report
Acta medica academica, 2015
Nasopharyngeal carcinoma is an extremely rare pediatric malignancy predominantly occurring in adolescent males. Its multifactorial pathogenesis is most strongly associated with the exposure to Epstein-Barr virus in genetically susceptible hosts. In younger patients, more aggressive biological behavior has been observed, although the overall survival is better compared to adults. Due to its rarity and nonspecific clinical presentation, the diagnosis in children is often delayed and misinterpreted. We report a case of a 16-year-old boy with stage IVB nasopharyngeal carcinoma. He presented with a painless palpable neck mass, nasal congestion and a history of occasional epistaxis and headaches. Four years after the completion of a multimodal treatment, the patient is in complete remission. Although exceedingly rare, pediatricians should consider nasopharyngeal carcinoma in the differential diagnosis of palpable neck masses, especially in male adolescents. A multidisciplinary approach in...
Nasopharyngeal carcinoma: recognizing the radiographic features in children
AJNR. American journal of neuroradiology
Children often present with enlargement of the nasopharyngeal soft tissues, which is usually due to benign hypertrophy of adenoids. The objective of this report is to emphasize that, although rare, nasopharyngeal carcinoma (NPC) does occur in children and can be diagnosed reliably when certain key radiographic features are recognized. The presenting scans of 11 patients with biopsy proven NPC were reviewed retrospectively by a CAQ-certified neuroradiologist. The age range was 12-17 years (median 15 years). Fifteen scans were reviewed, including 8 CT scans of the neck with intravenous contrast and 7 MR scans of the nasopharynx without and with gadolinium. All 11 patients had a nasopharyngeal mass. The nasopharyngeal mass had invaded the central skull base in 10 patients (91%). Widening of the petroclival fissure was present in 8 (73%) patients; all except one patient had accompanying skull base invasion. The tumor had extended into the adjacent parapharyngeal space in 6 (55%), the pt...
Frontiers in Pediatrics
ObjectivesTo investigate the clinical characteristics and prognosis of nasopharyngeal carcinoma (NPC) in children and adolescents in different age groups.Materials and methodsThe clinical data of 51 patients with NPC aged ≤ 18 years who were treated in Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine from January 2012 to May 2017 were retrospectively analyzed. The patients were divided into children group (≤12 years old) and adolescent group (12–18 years old) with 12 years old as the boundary. The clinical characteristics, diagnosis, treatment, and prognosis of the children and adolescent groups were compared.ResultsThe symptoms of the first diagnosis in the children group were mainly nasal congestion (P = 0.043) and ear symptoms (P = 0.008). The diagnosis rate of nasopharyngeal biopsy in the children group was lower (P = 0.001), while the rate of diagnosis of cervical mass biopsy was significantly higher than that in the adolescent group (P = 0.009). T...
Radiation oncology (London, England), 2014
BackgroundTo evaluate the clinical features, treatment results, prognostic factors and late toxicities of nasopharyngeal carcinoma in children and adolescents.MethodsBetween January 1990 and January 2011, 158 NPC patients younger than 20 years old were treated in our institution, and the patient¿s clinical characteristics, treatment modalities, outcomes and prognostic factors were retrospectively analyzed.ResultsThere were 9 (5.7%) patients in stage II, 60 (38.0%) in stage III and 89 (56.3%) in stage IV according to the UICC2002 staging system. Neck mass (32.3%), headache (21.5%) and nasal obstruction (15.2%) were the most common chief complaints. With a median follow-up time of 62.5 months (range 2.0-225.0 months), the 5-year overall survival (OS) rate, local-regional control (LRC) rate and distant metastasis-free survival (DMFS) rate were 82.6%,94.9% and 76.4%, respectively. There were 43 (27.2%) patients failed during the follow up, with seven local-regional recurrences and 38 di...
Nasopharyngeal carcinoma in children: Retrospective review of 50 patients
International Journal of Radiation Oncology*Biology*Physics, 1996
Purpose: To report a retrospective analysis of epidemiologic, clinical, and therapeutic aspects of 50 children with newly diagnosed nasopharyngeal carcinoma who were treated in a single institution over a period of 18 years. Methods and Materials: Thirty-two male and 18 female children ranging from 5 to 16 years, accounted for 7.2% of all nasopharyngeal carcinoma cases and 52% of childhood nasopharyngeal malignancies. Histopathology was World Health Organization Type 3 carcinoma in 45, World Health Organization Type 2 in 4, and World Health Organization Type 1 in one patient. Two of the patients had missing information for staging and treatment evaluation. Disease extent was T1 (n = 4), T2 (n = 9), T3 (n = 21), and T4 (n = 14); NO (n = 1), N1 (n = 6), N2 (n = 12), and N3(n = 29). Six patients had base of skull invasion, two had cranial nerve palsies, and six had both. One patient had M1 disease on admission. Twenty-three patients were treated with irradiation only. Thirteen patients received adjuvant, and 12 had neoadjuvant chemotherapy in addition to radiotherapy. Patients received 50-72 Gy to the primary tumor and involved nodes, and 45-50 Gy to uninvolved regions. Chemotherapy consisted of combinations including cisplatin, bleomycin, epirubicin, 5-flouroucil, and cyclophosphamide. Results: Thirty-eight (79%) patients attained locoregionel control. Overall, 22 patients are alive without relapse 6-195 months from diagnosis. Thirteen patients had 21 relapses, at local and/or regional sites (43%), distant sites (48%), or both (9%). The median time for first relapse was 8 months. Overall, the 5-and 10-year survival rates were 52 and 52%, respectively, and the failure-free survival rates were both 53 %. The results of three distinct treatments given in subsequent time periods were not statistically different. Three second malignancies occurred 33-156 months following nasopharyngeal carcinoma diagnosis. Conclusion: In the current series, nasopharyngeal carcinoma patients under the age of 16 accounted for 7.2% of all nasopharyngeal carcinoma cases. Whereas the impact of chemotherapy on long-term survival remains to be determined by randomized studies, the results suggest that more effective treatment regimens and long-term follow-up are necessary for children with nasopharyngeal carcinoma.
International Journal of Pediatrics and Child Health, 2019
Introduction: Nasopharyngeal carcinoma (NPC) in children and adolescents is a relatively rare yet highly malignant disease. Clinical presentation of NPC in this age group is non-specific and varied leading to a predominantly late diagnosis. The objective of this paper is to explore and clarify the tumour’s ambiguity and assess the precision of imaging in mapping its morphology and loco-regional extension and possible distant metastases. Treatment regimes that minimize adverse radio-therapeutic effects on surrounding structures will be highlighted. Method: Retrospective analysis and observations of literature (in English) between 2004 to December 2017 was performed. A search was performed using the Medline data-base. The following are the search terms: “children”, “nasopharyngeal carcinoma”, “symptoms’, “imaging” and “therapy”. Material: Of the 43 papers found on the primary search only 36 satisfied the search criteria. Four review papers of the primary search were retained as source...
Nasopharyngeal carcinoma in a six-year-old female child: a case report
Pediatria Polska
Nasopharyngeal carcinoma (NPC) is an extremely rare malignancy among the paediatric age group. The relative rarity of paediatric NPC makes the diagnosis difficult. Consequently, NPC tends to be locally advanced at the time of diagnosis in the paediatric age group and is sometimes associated with distant metastasis. The diagnosis of paediatric NPC should prompt immediate treatment. We report a case of undifferentiated nasopharyngeal carcinoma in a young girl who presented with advanced loco-regional disease and was treated with chemoradiation.
Nasopharyngeal carcinoma in children under 15 years of age: A retrospective review of 65 patients
Annals of Oncology, 1999
Background: Nasopharyngeal carcinoma constitutescomprises up to 5% of primary childhood cancers but literature lacks modern uniformly treated large series. Patients and methods: A retrospective review was performed of sixty-five previously untreated patients younger than 16 years of age diagnosed and treated at the Ibn Rochd Centre in Casablanca between 1988 and 1992. Forty-four percent of them were stage T3 toT 4 and 66% stage N 2 or N3. All patients were irradiated. Prior adjuvant chemotherapy was administered in 33 patients. Thirteen patients were lost to follow-up. Results: Local control was obtained in 85% of the 52 evaluable patients. The five-year overall survival was 42% and disease-free survival 38%. Ten relapses occurred at local and/or regional sites. Six patients have distant metastases. All 24 patients with relapse or persistent disease died despite salvage therapy. Stage, histology and dose of radiation, were statistically significant prognostic variables. Patients treated with chemotherapy followed by irradiation had a better outcome than those treated with radiation alone. Conclusions: Nasopharyngeal carcinoma in children is a rare chemosensitive tumor. However, conclusive treatment guidelines cannot be drawn from this series and prospective cooperative studies are needed for the development of more effective and less toxic therapeutic strategies.