An extremely rare malignant tumour of nasopharynx: primary nasopharyngeal non salivary type adenocarcinoma

Authors

  • Emelda Rose Sebastin Department of Otorhinolaryngology, Hospital Sibu, Sarawak, Malaysia
  • Piriya Darishini Department of Otorhinolaryngology, Hospital Sibu, Sarawak, Malaysia
  • Tang Chian Ling Department of Otorhinolaryngology, Hospital Sibu, Sarawak, Malaysia
  • Heng Pek Ser Department of Otorhinolaryngology, Hospital Sibu, Sarawak, Malaysia

DOI:

https://doi.org/10.18203/issn.2454-5929.ijohns20220148

Keywords:

Nasopharyngeal adenocarcinoma, Nasopharyngectomy, Radiotherapy

Abstract

Adenocarcinoma is commonly found in lung, prostate and gastrointestinal tract. Nasopharyngeal part contributes a very small percentage of adenocarcinoma as the most common histopathology found here is squamous cell carcinoma. We present a case of nasopharyngeal adenocarcinoma which is a very rare clinical presentation. This is 35 years old Iban gentleman, with underlying retroviral disease, hepatitis B on treatment, presented with right neck swelling for 3 months associated with right ear fullness. Examination showed unilateral right level II neck swelling and nasal endoscopy showed mass arising from right fossa of Rosen muller (FOR). The investigation done includes biopsy of right FOR and biopsy of right neck swelling with contrast enhanced computed tomography of neck, thorax and abdomen. The result of right FOR biopsy is non intestinal type adenocarcinoma, and biopsy of right neck swelling is reported as metastatic undifferentiated carcinoma. CECT NTAP showed asymmetry with fullness of right FOR associated with right level II cervical lymphadenopathy. Our centre managed this case with surgical intervention and patient underwent endoscopic nasopharyngectomy, and planned for right modified radical neck dissection (MRND). Patient defaulted our follow up after operation and was not keen for neck dissection surgery. He presented the second time with bilateral neck swelling and underwent chemotherapy and defaulted the follow up thereafter again. In conclusion the approach in treatment for nasopharyngeal carcinoma (NPC) and sino-nasal adenocarcinoma differs whereby the cornerstone management for the latter one is surgical intervention compared to the former which is radiotherapy. Hence early detection and treatment is essential.

Author Biography

Emelda Rose Sebastin, Department of Otorhinolaryngology, Hospital Sibu, Sarawak, Malaysia

Department of Otorhinolaryngology

Medical Officer

References

Paulino A. Nasopharyngeal Cancer Clinical Presentation: History, Physical, Causes. 2017. Available at: https://emedicine.medscape.com/ article/988165-clinical. Accessed on 26 Feb 2020.

Ahmad A, Stefani S. Distant metastases of nasopharyngeal carcinoma: a study of 256 male patients. J Surg Oncol. 1986;33(3):194-7.

Alapati S, Unsal A, Cracchiolo J, Roman B, Lee N, Cohen M. Incidence and Distribution of Nodal Metastases in Sinonasal Malignancy. Int J Radiation Oncol Biol Physics. 2018;100(5):13842.

Xu T, Li ZM, Gu MF. Primary nasopharyngeal adenocarcinoma; a review. Asia Pac J Clin Oncol. 2012;8(2):123-31.

Cancer.Net. Nasopharyngeal Cancer-Types of Treatment. 2021. Available at: https://www.cancer. net/cancer-types/nasopharyngeal-cancer/types-treatment. Accessed on 25 October 2021.

Lai YS. Exclusively Endoscopic Resection of Nasopharyngeal Adenocarcinoma; Clin Exp Otorhinolaryngol. 2013:6(4):263-5.

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Published

2022-01-25

Issue

Section

Case Reports