Undifferentiated Nasopharyngeal Carcinoma Presenting with Shoulder Mass.

Cosphiadi Irawan,Reyhan Eddy Yunus,Rahmat Cahyanur

doi:10.1155/2020/2586248

Cosphiadi Irawan, Reyhan Eddy Yunus + Show 1 more

Open Access

https://doi.org/10.1155/2020/2586248

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Abstract

Nasopharyngeal cancer (NPC) is the most common cancer among head and neck cancer that usually presented with unilateral neck mass. Unusual symptoms of NPC can lead us to diagnosis misleading and delayed definitive treatment. We present a case of NPC with bone metastasis in the shoulder. A 33-year-old female presented with right shoulder mass caused by undifferentiated carcinoma of unknown primary, based on biopsy of shoulder mass. After four months, she was complaining painless neck swelling, headache, and hearing impairment in the left ear. Bone MRI showed malignant bone tumour in the right humerus. Neck CT scan showed mass in the nasopharyngeal and bilateral lymphadenopathy. Biopsy in nasopharyngeal revealed undifferentiated carcinoma of nasopharyngeal cancer (WHO-3 type A). The patient was diagnosed as NPC stage IVb and thus was treated with palliative chemotherapy. After three cycles of cisplatin docetaxel, patient condition improved.

Highlights

Nasopharyngeal cancer (NPC) is the most common head and neck cancer
The case that undifferentiated carcinoma of unknown primary based on biopsy result could be end up in NPC, especially in an endemic area, is important to us
At the moment of shoulder mass being diagnosed, the patient only had mild headache without other symptoms associated with NPC

Summary

Introduction

Nasopharyngeal cancer (NPC) is the most common head and neck cancer. Southeast Asia including Indonesia is the area with high prevalence of NPC cases. The most common presenting sign of NPC is unilateral neck mass (approximately 80% cases) [2]. Suzina and Hamzah reported in Malaysia that unilateral neck mass was the most common presenting symptom (37.5%) [3]. Lee et al studied 5020 patients in Hong Kong and showed that neck mass was found in 37.3%. This article would like to report a rare clinical presentation of NPC that came to medical facilities due to right shoulder mass. The case that undifferentiated carcinoma of unknown primary based on biopsy result could be end up in NPC, especially in an endemic area, is important to us

Case Presentation

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Discussion