Nasopharyngeal carcinoma overview: Difference between revisions

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==Causes==
==Causes==


Common causes of nasopharyngeal carcinoma include [[Epstein-Barr virus]] (EBV) infection and [[nitrosamines]] consumption in diet.
Common causes of nasopharyngeal carcinoma include [[Epstein-Barr virus]] (EBV) infection and [[nitrosamines]] consumption.


==Differentiating Nasopharyngeal carcinoma from other Diseases==
==Differentiating Nasopharyngeal carcinoma from other Diseases==

Revision as of 12:10, 24 September 2015

Nasopharyngeal carcinoma Microchapters

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Overview

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Faizan Sheraz, M.D. [2]

Overview

Nasopharyngeal carcinoma (NPC) is a cancer originating in the nasopharynx (the uppermost region of the pharynx), where the nasal passages and auditory tubes join the remainder of the upper respiratory tract. NPC differs significantly from other cancers of the head and neck in occurrence, causes, clinical behavior, and treatment. It is vastly more common in certain regions of East Asia and Africa than elsewhere, with viral, dietary, and genetic factors implicated in its causation. Head and neck MRI may be helpful in the diagnosis of nasopharyngeal carcinoma. The mainstay of therapy for nasopharyngeal carcinoma is external beam radiotherapy.

Historical Perspective

Classification

Nasopharyngeal carcinoma may be classified according to microscopic features into 3 subtypes: well-differentiated, moderately-differentiated, and undifferentiated type.

Pathophysiology

On microscopic histopathological analysis, abundant dense eosinophilic cytoplasm and prominent lymphoid component are characteristic findings of nasopharyngeal carcinoma.

Causes

Common causes of nasopharyngeal carcinoma include Epstein-Barr virus (EBV) infection and nitrosamines consumption.

Differentiating Nasopharyngeal carcinoma from other Diseases

Nasopharyngeal carcinoma must be differentiated from normal adenoidal tissue, nasopharyngeal lymphoma and chordoma.[1]

Epidemiology and Demographics

The prevalence of nasopharyngeal carcinoma is approximately 1 per 100,000 individuals in the USA. Patients of all age groups may develop nasopharyngeal carcinoma.

Risk Factors

Common risk factors in the development of nasopharyngeal carcinoma are Chinese (or Asian) ancestry, Epstein-Barr virus (EBV) exposure, and heavy alcohol intake.

Screening

According to the America Cancer Society, screening for nasopharyngeal carcinoma is not recommended.[2]

Natural History, Complications and Prognosis

If left untreated nasopharyngeal carcinoma produces few symptoms early in course. Non-keratinizing nasopharyngeal carcinoma is associated with a 5 year survival rate of 65%. The common complications of nasopharyngeal carcinoma include airway obstruction, dysphagia, and disfigurement of the neck or face.

Staging

The staging of nasopharyngeal carcinoma is based on the TNM staging system.

History and Symptoms

Symptoms of nasopharyngeal carcinoma include swelling in the neck, cough, sore throat and weight loss.[3]

Physical Examination

Patients with nasopharyngeal carcinoma usually appear normal. Physical examination of patients with nasopharyngeal carcinoma is usually remarkable for neck swelling, hearing loss and nasal obstruction.

Laboratory Findings

Laboratory findings consistent with the diagnosis of nasopharyngeal carcinoma include an elevated concentration of serum EBV titer.

CT

On the head and neck CT scan, nasopharyngeal carcinoma is characterized by soft tissue masses most commonly centered at the lateral nasopharyngeal recess (fossa of Rosenmüller).

MRI

Head and neck MRI may be helpful in the diagnosis of nasopharyngeal carcinoma. Findings on MRI suggestive of nasopharyngeal carcinoma include dural thickening and bone marrow infilteration.

Medical Therapy

The mainstay of therapy for nasopharyngeal carcinoma is external beam radiotherapy, supplemented in some cases with chemotherapy.

Surgery

Surgery is not the first-line treatment option for patients with nasopharyngeal carcinoma.

References

  1. http://radiopaedia.org/articles/nasopharyngeal-carcinoma
  2. Can nasopharyngeal cancer be found early? American Cancer Society (2015) http://www.cancer.org/cancer/nasopharyngealcancer/detailedguide/nasopharyngeal-cancer-detection Accessed on September, 16 2015
  3. Richard Cote, Saul Suster, Lawrence Weiss, Noel Weidner (Editor). Modern Surgical Pathology (2 Volume Set). London: W B Saunders. ISBN 0-7216-7253-1.


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