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Nasopharyngeal carcinoma (NPC) is one of the rarest malignancies and carries a high risk of morbidity and mortality. The presentation of the disease depends on the stage and the anatomical relation of the lesion. In this case report, we present a case of a young female patient, who was found to have a pedunculated nasopharyngeal mass upon examination. The patient presented with nasal obstruction, which improved after surgical removal of the lesion. A histopathological examination of the resected mass revealed an undifferentiated squamous cell carcinoma type, which usually arises as an exophytic raised mass and not a pedunculated mass as in this case.

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Background: IgG4-related disease (IgG4-RD) was characterized by single or multiple masses in organs, which may mimic various inflammatory and malignant diseases. Here, we summarize 4 patients with aggressive manifestations of IgG4-RD that mimic nasopharynx cancer to provide some new sights for the diagnosis of IgG4-RD. Case summary: Four patients were included in our series. The age ranged from 53 to 64 years old, and the duration of the disease ranged from 4 to 6 months. The chief complaints included headache, rhinorrhea, or diplopia. All patients had more than 10 IgG4+ plasma cells/HPF in immunohistochemistry with plasma lgG4 levels ranging from 218 mg/dL to 765 mg/dL. All of them met the diagnostic criteria of lgG4-RD. Conclusion: The described case is highly similar to the clinical manifestations of nasopharyngeal carcinoma. Although pathology is the gold standard, there are still limitations. Serological IgG4 can help confirm the diagnosis. Timely diagnosis of IgG4-RD is of great significance in preventing secondary organ damage in patients with active diseases.

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Nasopharyngeal branchial cleft cysts (NBC) are generally single, unilateral, and asymptomatic. They may get infected or produce obstructive symptoms as it enlarges. The definitive diagnosis is usually confirmed by Magnetic resonance imaging (MRI) and histopathology. A 54-year-old male patient presented with progressive bilateral nasal obstruction, more on the right side, associated with hyponasal voice and postnasal discharge of 2 years' duration. A cystic mass was found by nasal endoscopy on the lateral right side of the nasopharynx, extending to the oropharynx, and was confirmed with MRI findings. Uneventful total surgical excision and marsupialization were done with follow up of nasopharyngeal endoscopic examination on each visit. The pathological features and the site of the cyst were compatible with a second branchial cleft cyst. Although rare, NBC should be considered one of the differential diagnoses of nasopharyngeal tumors. Surgical excision and marsupialization are the main treatment with low complication and recurrence rates.

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OBJECTIVES: To highlight a case of nasopharyngeal Respiratory Epithelial Adenomatoid Hamartoma (REAH) in a female patient with chronic nasal block. METHODS: A single case report of a female patient with the diagnosis of REAH, detailing her presenting symptoms, clinical findings, management and follow up. RESULTS: Histopathological assessment of the excised nasopharyngeal polyp was consistent with a diagnosis of REAH with a discussion on the disease and its current literature reviews. CONCLUSION: The incidence of REAH within the nasopharynx remain rare with only few cases described in literature, especially in females.

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Introduction: Primary nasopharyngeal tuberculosis (NPTB) is a rare disease but should not be missed as one of the differential diagnoses for cervical lymphadenopathy or nasopharyngeal mass. Case Report: We describe a case of a 38 year old lady, who presented with bilateral cervical lymphadenopathy associated with intermittent fever. Nasoendoscopy examination and computed tomography scan of the neck revealed a centrally located mass predominantly at the left posterior nasopharyngeal wall without obliteration of both fossae of Rosenmuller. Typical histopathological features of necrotizing granulomatous lymphadenitis together with the common clinical presentation of cervical lymphadenopathy and nasoendoscopy findings of nasopharyngeal mass conclude the diagnosis of nasopharyngeal tuberculosis. With anti-tuberculous therapy, the cervical lymphadenopathy and nasopharyngeal mass were completely resolved. Conclusion: Nasopharyngeal tuberculosis is an uncommon disease with great diagnostic challenges and with early diagnosis and adequate treatment, NPTB carries a good prognosis with complete disease resolution.

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BACKGROUND: We describe an unusual presentation of EBV-associated mucocutaneous ulcer presenting as a large tumor of the nasopharynx in an immune suppressed child. This condition is newly characterized and has not been well-studied in the otolaryngology literature. CASE REPORT: Our patient is a 12-year-old female undergoing chemotherapy for T-cell acute lymphoblastic leukemia who presented with progressively severe headaches, nasal obstruction, facial pain/pressure, photophobia, fever and otalgia associated with neutropenia and refractory to empiric antibiotic therapy. Bedside nasal endoscopy and imaging revealed signs of acute sinusitis and a large nasopharyngeal mass suspicious for neoplasm. The mass was eccentric to the right and distending the right fossa of Rosenmuller. She underwent endoscopic sinus surgery and biopsy of her nasopharyngeal mass. Pathologic analysis of the nasopharyngeal mass revealed EBV-positive mucocutaneous ulcer. CONCLUSION: This is an unusual presentation of a rare entity. EBV-positive mucocutaneous ulcer warrants awareness among otolaryngologists and is not well-described in our literature.

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Tuberculosis remains a major cause of morbidity and mortality globally, with a global total of about 10 million people falling ill with it in 2020. Until the coronavirus (COVID-19) pandemic, tuberculosis was the leading cause of death from a single infectious agent. Nasopharyngeal tuberculosis is a rare type of extrapulmonary tuberculosis that may be either primary or secondary to pulmonary tuberculosis. Nasopharyngeal tuberculosis may be mistaken for nasopharyngeal carcinoma as both conditions may present with a nasopharyngeal mass and cervical lymph node enlargement. We present a case of nasopharyngeal tuberculosis secondary to pulmonary tuberculosis who presented without any nasal or respiratory symptoms. The patient presented with a cervical lymph node enlargement and a nasopharyngeal mass was detected on nasal endoscopy. Fine needle cytology from the cervical node and the initial biopsy report from the nasopharyngeal mass were not confirmatory, causing a diagnostic dilemma. A repeat biopsy from the nasopharyngeal mass with the demonstration of caseating granuloma and acid-fast bacilli in the specimen pointed to the diagnosis of nasopharyngeal tuberculosis. The patient responded well to the standard 6-month anti-tubercular regimen. Nasopharyngeal tuberculosis may mimic nasopharyngeal carcinoma and a repeat biopsy may be necessary to confirm the diagnosis.

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BACKGROUND: Nasopharyngeal oncocytic lesions are a spectrum of benign lesions that represent a reactive or hyperplastic response to chronic inflammation. Though oncocytic lesions are typically asymptomatic, unilateral, and benign, this article discusses a rare case of large, bilateral oncocytic cysts and downstream otologic sequelae with a focus on identifying and discussing similar disease processes. METHODS: Case report and literature review.Case Presentation: A 67-year-old patient with 57 pack year smoking history presented for one year of left sided hearing loss and aural fullness. Clinic endoscopic exam demonstrated severe inflammatory and cystic changes lining the bilateral tori. Imaging and tissue sampling confirmed the cause was minor salivary gland cysts with papillary projections lined by oncocytic cells within bilateral tori tubarius. He was successfully treated with myringotomy with pressure equalizing tube, counseling on tobacco cessation, and surveillance with serial nasopharyngoscopy. CONCLUSIONS: Chronic eustachian tube dysfunction is a possible rare presentation and sequelae of large oncocytic cysts of the nasopharynx. Oncocytic cysts should be considered on the differential diagnosis for nasopharyngeal masses causing such dysfunction.

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Benign adenoidal hypertrophy is the most common cause of nasopharyngeal obstruction. However, depending on size and location, masses may cause nasopharyngeal obstruction. We present our experiences with a ten-year-old female who presented with what appeared to be a large nasopharyngeal mass that was initially favored to be malignant and was ultimately found to be adenoid hypertrophy related to acute infection with adenovirus.

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A 3-year-old female presented for evaluation of progressive snoring since birth. MRI revealed a fatty-appearing mass measuring 2.4 cm × 1.5 cm x 3.0 cm arising from the predental space of C1 and extending anteriorly through the prevertebral space into the retropharyngeal space. The patient underwent endoscopic trans-oral excision of the mass using electrocautery and blunt dissection, and pathological analysis yielded a diagnosis of fibrolipoma. CT imaging twelve months post-surgery showed no recurrence, and the patient remains symptom free two years later. Very few reported cases of nasopharyngeal fibrolipomas exist, and this is the first report of 2-year clinical follow-up.

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Skull base chordomas are rare, malignant tumors arising from primitive notochord remnants of the axial skeleton and comprise approximately 25–35% of all chordoma cases. Nasal endoscopy in previous case reports has characterized nasopharyngeal chordomas as firm, semi-translucent masses protruding from the posterior nasopharyngeal wall with a pink, “meaty” appearance. However, the nasopharyngeal chordoma in the present case had a soft, cystic appearance, unlike the tumors previously described. Herein, an unusual case of an incidentally discovered nasopharyngeal chordoma is reported in a patient with papillary thyroid cancer; the discovered chordoma had a benign cystic appearance with no abnormal positron emission tomography-computed tomography (PET-CT) uptake.

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PURPOSE: Juvenile nasopharyngeal angiofibroma (JNA) is a rare tumor that exhibits a predictable spreading pattern. Radiologist's prior knowledge on the tumor's characteristics aids in establishing a diagnosis. We aimed to report the characteristic Magnetic Resonance Imaging (MRI) findings and the spread patterns of JNA. MATERIALS AND METHODS: We retrospectively evaluated the MRI findings and extension pathways of 6 cases of JNA. RESULTS: The patients' age ranged from 8 to 16 years and all patients were male. The tumors were classified according to the Onerci system. Tumors were largely isointense to muscle on T1-weighted images and hyperintense on T2-weighted images. All lesions had internal signal-void regions and all exhibited intense enhancement after IV contrast injection. Diffusion restriction was not an associated feature. ADC values for these tumors were high. The evaluation of the available MR angiography studies of three patients showed the blood supply to the tumor to be mainly from the internal maxillary branch of the external carotid artery. In all patients, the diagnosis was based on MR images and a surgical excision was planned. CONCLUSION: The diagnosis can be established based on the characteristic imaging findings and the clinical history without performing a biopsy.

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@#<p style="text-align: justify;"><strong>OBJECTIVES:</strong> To determine the prevalence and identify the types of Nasopharyngeal Carcinoma (NPCA) among patients with nasopharyngeal mass seen at a tertiary university training hospital in  the  Philippines  from  January  2006  -  July  2012  and  identify  possible  factors associated  with nasopharyngeal carcinoma.<br /><strong>METHODS:</strong> A  retrospective  cross-sectional  study  was  performed  at  a  tertiary  university  training hospital among cases (n=179) seen with nasopharyngeal mass at the ENT outpatient department. Histopathology results and patient medical charts were collected and reviewed after IRB approval. The  age  at  diagnosis,  sex,  place  of  residence,  occupation  and  chief  complaint  was  compared among patients with positive histopathology of NPCA only. <br /><strong> Design:</strong> Retrospective, cross sectional study<br /><strong> Setting:</strong> Tertiary Private University Training Hospital<br /> <strong>Participants:</strong> One hundred seventy nine (179) patients with nasopharyngeal mass<br /><strong>RESULTS:</strong> Ninety six (54%) cases with nasopharyngeal mass seen at the ENT outpatient department were positive for nasopharyngeal malignancy. The remaining 83 (46%) cases with nasopharyngeal mass had a benign histopathology. NPCA was more common among males (58%) than females (42%).  The  most  common  form  of  NPCA  was  non-keratinizing  undifferentiated  NPCA  (47%) followed by poorly differentiated squamous cell carcinoma in 18 (19%). The most common chief complaint was a neck mass, followed by decreased hearing.<br /><strong>CONCLUSION:</strong> There  was  a  higher  proportion  of  nasopharyngeal  malignancy  among  male patients  with  nasopharyngeal  mass,  and  the  most  common  chief  complaint  was  a  neck  mass. Future  research  should  integrate  data  with  other  hospital  institutions  to  obtain  more  accurate demographic  data  of  the  local  prevalence  of  NPCA.  A  detailed  record  of  the  ethnicity,  diet, occupation, smoking history and family history of cases should be obtained to correlate possible risk factors of NPCA among patients with nasopharyngeal mass in our setting.</p>

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Meningiomas are generally slow-growing benign tumors associated with the dura. They form lumps that mostly grow extra-axially, by repulsing, rather than infiltrating the surrounding neural parenchyma. Majority of meningiomas are intracranial. However, although rare, meningioma formation has been reported in almost all other organs. We report the case of a patient with an extra-neuraxial meningioma presenting as a nasopharyngeal mass.

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While the nasopharynx is most commonly regarded by the otolaryngologist as a primary site of neoplastic involvement, it is also an avenue of spread of base-of-the-skull tumors presenting as bulging nasopharyngeal masses. Chordoma is a relatively rare tumor of the skull base and sacrum thought to originate from embryonic remnants of the notochord. Chordomas arising from the skull base/clivus are typically locally aggressive with lytic bone destruction. The optimal treatment may be photon/proton radiotherapy alone or combined with a gross total resection, when feasible. We report a case of intracranial chordoma presenting as nasopharyngeal mass.

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Spheno-occipital chordomas can rarely present as nasopharyngeal mass. Metastases occur only in advanced disease. They can pose a diagnostic dilemma when information about diagnosis of the primary tumor is not available. We present cytological findings in upper cervical lymph node of a case of nasopharyngeal chordoma and discuss possible differential in such a location.

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Anaplastic lymphoma kinase (ALK)-positive diffuse large B-cell lymphoma is a rare and distinct variant of diffuse large B-cell lymphoma with characteristic morphologic, immunophenotypic, and cytogenetic features. We report a case of ALK-positive diffuse large B-cell lymphoma in a 44-year-old male with progressively worsening unilateral nasal congestion and obstruction secondary to a nasopharyngeal mass. Radiologically, the mass was showed to extend to orophanrynx from nasopharynx. Histologically, the tumor cells exhibited plasmablastic morphology with expression of Bob-1, CD4, CD10, CD45, CD56, CD138, EMA, MUM1, Oct-2, and kappa immunoglobulin light chain, but negative for CD20, CD30, CD79a, PAX-5, and lambda. More importantly, the neoplastic cells showed positive immunoreactivity for ALK with exclusive cytoplasmic granular staining pattern. This case represented the second reported ALK-positive diffuse large B-cell lymphoma in the nasopharyngeal region.

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OBJECTIVES: 1. To present a rare case of a true teratoma of the nasopharynx in a Filipino newborn. 2. To present a rational diagnostic and management approach to the case. DESIGN: Case report SETTING: Tertiary Government Hospital PATIENT: One female newborn RESULTS: A newborn presented with a congenital large naso-oropharyngeal mass. She did not present with signs of airway obstruction. The oral mass was found to be attached to the nasopharynx. The initial consideration was a teratoma. The patient also manifested with an incomplete cleft palate and dermoid cyst on the left eye. Contrast CT scan confirmed the attachment of the mass to the left nasopharyngeal wall. The mass was subsequently resected and delivered transorally. The final histopathology showed teratoma. Otorhinolaryngologic management of this case encompassed the following priorities: (1) ensuring vital & vegetative function (airway & feeding), (2) examination of the newborn for concomitant congenital anomalies, (3) resection of the mass after accurate delineation of its extent and dimensions and (4) planning for future repair of the palatal defect. CONCLUSION: True teratomas of the nasopharynx are rare lesions (originating from the 3 embryonic germ cell layers). Airway management is the first priority of the otorhinolaryngologist in these cases because of potential to cause upper airway obstruction. (Author)

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Out of 36511 patients attending the ENT OHD of R. G,. Aur Medical Callege & Hospital. Kolkata, in one year 0.08% patients were found tuning naspharyngeal mass. 30 cases of nasopharyngeal mass were studied. The peak incidence of nasopharyngeal mass was in the age group between II to 20 years (40%). The incidence in males (73%) was more than females(27%). The maximum ineldence was found among students (74%). Commonest ntuopharyngeal nuns teas antrochoanal polyp (30%). Next commlon masses were adenoids (23%)Juvenile angwfibroma(20%) and nasophartngeal carcinoma (13%). Nasal obstruction was the main presenting symptom(83%) followed by epistaxis (40%).