Abstract
BackgroundNasopharyngeal carcinoma (NPC) is a frequent head and neck cancer in southern China and Southeast Asia. The majority of NPC patients are managed by radiation oncologists, medical oncologists and head and neck surgeons. Actually, neurosurgical interventions are warranted under specific circumstances. In this article, we described our experience as neurosurgeons in the management of NPC patients.MethodsMedical records of NPC patients who received neurosurgical procedure at Sun Yat-sen University Cancer Center were reviewed.ResultsTwenty-seven patients were identified. Among 27 cases, neurosurgical procedures were performed in 18 (66.7%) with radiation-induced temporal necrosis, 2 (7.4%) with radiation-induced sarcoma, 4 (14.8%) with synchronous NPC with primary brain tumors, 2 (7.4%) with recurrent NPC involving skull base, and 1 (3.7%) with metachronous skull eosinophilic granuloma, respectively. The diagnosis is challenging in specific cases and initial misdiagnoses were found in 6 (22.2%) patients.ConclusionsFor NPC patients with intracranial or skull lesions, the initial diagnosis can be occasionally difficult because of the presence or a history of NPC and related treatment. Unawareness of these entities can result in misdiagnosis and subsequent improper treatment. Neurosurgical interventions are necessary for the diagnosis and treatment for these patients.
Highlights
Nasopharyngeal carcinoma (NPC) is a frequent head and neck cancer in southern China and Southeast Asia
A total of 27 cases were identified. Among these patients were eighteen (66.7%) with radiation-induced temporal necrosis (RITN), two (7.4%) with radiation-induced sarcoma (RIS), four (14.8%) with synchronous NPC with primary brain tumors, two (7.4%) with recurrent NPC involving the base of the skull, and one (3.7%) with metachronous skull eosinophilic granuloma (EG)
RITN presented on magnetic resonance (MR) images as a nodule with heterogeneous enhancement (Figure 1a and b) in nine cases and as obvious cystic formation (Figure 1c and d) in the other nine patients
Summary
Nasopharyngeal carcinoma (NPC) is a frequent head and neck cancer in southern China and Southeast Asia. The majority of NPC patients are managed by radiation oncologists, medical oncologists and head and neck surgeons. We described our experience as neurosurgeons in the management of NPC patients. Nasopharyngeal carcinoma (NPC) is one of the most prevalent malignancies in southern China and Southeast Asia. In a Chinese endemic area, the incidence rate of NPC reaches as high as 27.2 per 100,000 person-years in men [1]. NPC is more significantly frequent in Chinese immigrants in the United States [2]. NPC has been demonstrated to have a high response rate to a series of 27 cases in which neurosurgeons play a critical role in the management of patients with NPC
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