nasopharyngeal cancer
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.