Persistent otitis media with effusion - an unusual type of nasopharyngeal adenocarcinoma

Athina Zarachi Athina Zarachi,Alkistis Tsikou Alkistis Tsikou,Ioannis Komnos Ioannis Komnos,Stefania Gkoura Stefania Gkoura,Zoi Evangelou Zoi Evangelou,Angelos Liontos Angelos Liontos,Ioannis Kastanioudakis Ioannis Kastanioudakis

doi:10.30574/ijsra.2021.3.2.0145

Athina Zarachi Athina Zarachi, Alkistis Tsikou Alkistis Tsikou + Show 5 more

Open Access

https://doi.org/10.30574/ijsra.2021.3.2.0145

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Abstract

We present the case of a 41-year-old male patient that examined in the outpatient ENT Department of our hospital, reported a persistent otitis media for about six months. Despite medical therapy, his symptom did not improve. The suspicious of a nasopharyngeal mass was raised and the rhino endoscopy revealed a mucosal projection in the left fossa of the Rosenmuller. Computed tomography (CT) of temporal bone pneumatization showed a left mastoid cell occupation and a small projection in the left fossa of the Rosenmuller. The histological examination result of a biopsy of the lession that prepared under local anesthesia, revealed nasopharyngeal adenoid cystic carcinoma. Magnetic resonance imaging indicated the extent of the tumor. The positron emission tomography/computed tomography (PET/CT) scan staged the patient and concluded the diagnosis. The patient underwent both surgery and radiotherapy and addressed oncologists and radiotherapists for further treatment. The patient was diagnosed with lung and kidney metastasis. Adenoid cystic carcinoma is a rare type of adenocarcinoma with ominous prognosis. We always have to raise the suspicious of nasopharyngeal carcinoma, in patients with persistent otological symptoms, that do not improve despite therapy.

Highlights

Nasopharyngeal carcinoma (NPC) occurs in the epithelial lining of the nasopharynx, and has a variety of subtypes, pathologically
We present the case of a 41-year-old male patient that examined in the outpatient ENT Department of our hospital, reported a persistent otitis media for about six months
The histological examination result of a biopsy of the lession that prepared under local anesthesia, revealed nasopharyngeal adenoid cystic carcinoma

Summary

Introduction

Nasopharyngeal carcinoma (NPC) occurs in the epithelial lining of the nasopharynx, and has a variety of subtypes, pathologically. Subtypes of nasopharyngeal salivary gland-type adenocarcinoma include the mucoepidermoid adenocarcinoma, the adenoid cystic adenocarcinoma , the polymorphous low-grade adenocarcinoma and the malignant mixed tumor, that come from different cell population and appear different prognosis[3,4,5,6]. We present the case of a patient reported otological symptoms for about six months His symptoms did not improve despite therapy, so he decided to address our clinic, for further investigation. 2. Case report A 41-year-old male patient examined in the outpatient ENT Department of our hospital, during January of 2019. Case report A 41-year-old male patient examined in the outpatient ENT Department of our hospital, during January of 2019 He reported left ear pain, hearing loss and ear fullness for about six months. The rhinoednoscopy of the nasopharynx revealed a small projection in the left fossa of Rosenmuller (Figure 1)

Discussion

Conclusion

Findings

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