Carcinoma ; Humans ; Limbic Encephalitis ; diagnosis ; surgery ; Male ; Middle Aged ; Nasopharyngeal Neoplasms ; diagnosis ; surgery

Diagnosis, Differential ; Female ; Humans ; Infant, Newborn ; Nasopharyngeal Neoplasms ; pathology ; surgery ; Polyps ; pathology ; surgery ; Teratoma ; pathology

OBJECTIVE/strong: To describe a case of juvenile angiofibroma with unusual protrusion out of the nasal cavity, and its management with surgery and radiotherapy.br /br /strongMETHODS:/strong br /strongDesign/strong: Case Report br /strongSetting/strong: Tertiary Public Referral Centre br /strongPatient/strong: Onebr /br /strongRESULTS/strong: A 17-year-old gentleman presented with a huge tumor protruding from his left nostril, diagnosed with juvenile angiofibroma stage IlIA by MRI and angiography. Following successful pre-operative embolization, the protruding mass was ligated and truncated, followed by surgical resection via external approach. Post-operative residual tumor was treated with adjuvant radiotherapy. There was no evidence of recurrence after nine months.br /br /strongCONCLUSION/strong: A high index of suspicion is of paramount importance in the diagnosis of JA and avoids the possibility of an unwarranted biopsy which could spell disaster. The most useful tools for diagnosis are MRI and arterial angiography. Treatment is primarily surgical. Irradiation therapy has been reported to achieve satisfactory outcomes, especially for unresectable residual disease and/or intracranial extension, where total surgical resection is unlikely to be attained without unacceptable morbidity./p
Human ; Male ; Adolescent ; Angiofibroma-diagnosis, radiotherapy, surgery ; Nasopharyngeal Neoplasms ; neoplasms ; Magnetic Resonance Imaging ; Nasal Cavity ; nose

Metastasis of nasopharyngeal carcinoma (NPC) to the dura, an extremely rare condition, can be symptomatically silent and mistaken for a benign entity radiographically. Missed diagnosis can lead to serious consequences or prove immediately fatal. We report a woman with dural metastasis of NPC that mimicked a meningioma on radiography. Craniectomy with tumour resection was performed due to rapid progression from the onset of symptoms to disability. The patient was still alive two years after surgery. This case emphasises the need to keep in mind the possibility of dural metastasis of NPC in patients with abnormal imaging features. This would not only avoid wrong and optimistic diagnosis, but also allow for appropriate treatment in a timely manner. To our knowledge, this is the first report of metastasis of NPC to the dura. We provide detailed information on the neoplastic lesion, which masqueraded as a benign entity and caused potentially fatal consequences.
Adult ; Brain Neoplasms ; diagnosis ; secondary ; surgery ; Carcinoma ; Diagnosis, Differential ; Disease Progression ; Dura Mater ; pathology ; Female ; Humans ; Magnetic Resonance Imaging ; Meningioma ; diagnosis ; pathology ; Nasopharyngeal Neoplasms ; diagnosis ; pathology ; Neoplasm Metastasis

Radiosurgery has been rarely applied for juvenile nasopharyngeal angiofibroma (JNA) and cumulative reports are lacking. The authors report a case of successful treatment of recurred JNA with gamma knife surgery (GKS). A 48-yr-old man was presented with right visual acuity deterioration and brain magnetic resonance images (MRI) disclosed a 3 cm-sized intraorbital mass in the right orbit. He underwent a right fronto-temporal craniotomy and the mass was subtotally removed to preserve visual function. Histological diagnosis confirmed JNA in typical nature. However, the vision gradually worsened to fail four years after operation. MRI then showed regrowth of the tumor occupying most of the right orbit. GKS was done for the re-curred lesion. A dose of 17 Gy was delivered to the 50% isodose line of tumor mar-gin. During the following four-year follow-up period, the mass disappeared almost completely without any complications. Usually JNA can be exclusively diagnosed by radiological study alone. So this report of successful treatment of JNA with GKS may provide an important clue for the novel indication of GKS.
Visual Acuity ; Treatment Outcome ; Radiosurgery/*methods ; Neoplasm Recurrence, Local ; Nasopharyngeal Neoplasms/diagnosis/*surgery ; Middle Aged ; Male ; Magnetic Resonance Imaging ; Humans ; Brain/radiography ; Angiofibroma/diagnosis/*surgery ; Adolescent

OBJECTIVE: Analyzing the prognostic factors in endoscopic surgery of juvenile nasopharyngeal angiofibromas (JNA). METHOD: Forty-seven records of JNA, treated with the endoscopic, from 2002 to 2008 were reviewed retrospectively. Previous surgery in other hospitals, sites involved, whether selective embolization was performed before surgery, feeding vessels, operative techniques and follow-up results were recorded. Evaluated factors include previous surgery for resection of JNA, vascular supply from carotid artery, surgery after selective embolization, involvement of cavernous bone in the root of pterygoid process, greater wing of sphenoid bone, interpterygoid fossa, infratemporal fossa and orbit. Chi-square test was used. RESULT: Operations were done under general anesthesia. The follow-up time was 12 to 87 month (median 35 month). During follow up, six patients presented recurrent lesions. Chi-square test showed that deep invasion of the cavernous bone in the root of pterygoid process was related to recurrence (P<0.05). There was no statistically significant difference between other factors and recurrence. Imaging examination showed that recurrent tumor was around the root of pterygoid process. CONCLUSION Deep invasion of the cavernous bone in the root of pterygoid process which was related to recurrence deserve close attention before and after endoscopic surgery.
Adolescent ; Adult ; Angiofibroma ; diagnosis ; pathology ; surgery ; Child ; Endoscopy ; Humans ; Male ; Middle Aged ; Nasopharyngeal Neoplasms ; diagnosis ; pathology ; surgery ; Prognosis ; Recurrence ; Retrospective Studies ; Treatment Outcome ; Young Adult

Radiation-induced spinal cord gliomas are extremely rare. Since the first case was reported in 1980, only six additional cases have been reported.; The radiation-induced gliomas were related to the treatment of Hodgkin's lymphoma, thyroid cancer, and medullomyoblastoma, and to multiple chest fluoroscopic examinations in pulmonary tuberculosis patient. We report a case of radiation-induced spinal cord glioblastoma developed in a 17-year-old girl after a 13-year latency period following radiotherapy for nasopharyngeal rhabdomyosarcoma. MRI findings of our case are described.
Contrast Media/diagnostic use ; Female ; Gadolinium DTPA/diagnostic use ; Glioblastoma/*diagnosis/pathology/surgery ; Humans ; *Magnetic Resonance Imaging ; Nasopharyngeal Neoplasms/*radiotherapy ; Neoplasms, Radiation-Induced/*diagnosis/pathology ; Rhabdomyosarcoma/*radiotherapy ; Spinal Cord Neoplasms/*diagnosis/pathology/surgery

Actins ; metabolism ; Adenoma, Pleomorphic ; congenital ; metabolism ; pathology ; surgery ; Diagnosis, Differential ; Fibrosarcoma ; metabolism ; pathology ; Humans ; Infant ; Male ; Nasopharyngeal Neoplasms ; congenital ; metabolism ; pathology ; surgery ; Rhabdomyosarcoma ; metabolism ; pathology ; Salivary Gland Neoplasms ; congenital ; metabolism ; pathology ; surgery ; Vimentin ; metabolism

Nasopharyngeal cancer (NPC) is a common malignancy affecting Asian countries, especially the Chinese population. Treatment regimes and results have improved over the years with better overall survival outcome data. Radiotherapy with or without chemotherapy is successful in many patients. Local recurrences are treated with nasopharyngectomy or another course of radiotherapy. The upper cervical spine and skull base can also be involved in NPC patients. Possible aetiologies are osteoradionecrosis, chronic infection and tumour invasion. This article reviews the NPC involvement of C1-2 due to the various pathologies as well as the diagnostic and surgical treatment strategies. Three clinical cases that were surgically treated are discussed along with a review of the current literature.
Adult ; Aged ; Bone Neoplasms ; secondary ; Carcinoma ; Cervical Vertebrae ; drug effects ; radiation effects ; China ; Female ; Humans ; Male ; Middle Aged ; Nasopharyngeal Neoplasms ; diagnosis ; surgery ; Osteomyelitis ; diagnosis ; etiology ; surgery ; Osteoradionecrosis ; etiology ; Recurrence ; Spinal Fractures ; etiology ; Treatment Outcome

OBJECTIVETo evaluate the efficacy of endoscopic nasopharyngectomy in the management of recurrent nasopharyngeal cancers (NPC) and to identify the prognostic factors.

METHODSBetween January 2006 and March 2014, 71 patients who received endoscopic nasopharyngectomy for recurrent NPC were retrospectively reviewed. The sex and the age of the patients, T stage, and tumor necrosis were recorded. Correlation between clinicopathological features and survival time was analyzed. Kaplan-Meier analysis was used to calculate the disease overall survival, disease-specific survival, and disease-free survival rates. Cox multivariate regression analysis and ROC curve analysis were used to determine the predictive value of the parameters.

RESULTSThe median age of 71 patients with recurrent nasopharyngeal carcinoma was 51.0 years old. Male to female ratio was 2.9:1 (male: 53, female: 18). The lesions were staged as follows (AJCC, 2010, seventh edition): rT1, 27; rT2, 10; rT3, 19 and rT4, 15. All patients underwent successful endoscopic nasopharyngectomy. No patient was transferred to open approach. The mean operative time was 155 minutes. The average blood loss was 450 ml. Three patients needed intraoperative blood transfusion. No serious postoperative complications occurred. Postoperative follow-up time was 5-96 months. During follow-up, 48 cases survived, including that 7 patients survived with disease, 1 patient had pulmonary metastases, and 1 case had cervical lymph node metastasis. Two-year overall survival and disease-free survival rates were 74.0% and 60.5%, respectively. Five-year overall survival and disease-free survival rates were 39.0% and 31.9%, respectively. Multivariate analysis showed that tumor necrosis was an independent prognostic factor for survival in recurrent nasopharyngeal carcinoma patients (P=0.001).

CONCLUSIONEndoscopic nasopharyngectomy is a safe and effective procedure for the treatment of recurrent nasopharyngeal carcinoma.

Carcinoma ; Disease-Free Survival ; Endoscopy ; Female ; Follow-Up Studies ; Humans ; Kaplan-Meier Estimate ; Male ; Middle Aged ; Multivariate Analysis ; Nasopharyngeal Neoplasms ; diagnosis ; pathology ; surgery ; Neoplasm Recurrence, Local ; diagnosis ; pathology ; surgery ; Neoplasm Staging ; Otorhinolaryngologic Surgical Procedures ; Prognosis ; Retrospective Studies ; Survival Rate