An incidental nasopharyngeal carcinoma coexistent with primary nasopharyngeal tuberculosis

@#p style=text-align: justify;strongOBJECTIVE: /strongTo describe a case of nasopharyngeal carcinoma coexistent with primary nasopharyngeal tuberculosis and review the literature.METHODS:br /Design:/strong Case Reportbr /strongSetting:/strong Tertiary Public University Hospitalbr /strongPatient:/strong One RESULTS:/strong A 28-year-old man presented with recurrent sore throat and neck pain with clinically enlarged tonsils. He underwent a routine adenotonsilectomy. Histopathologic examination revealed non-keratinizing squamous cell carcinoma with caseating granulomatous inflammation typical for tuberculosis in the same adenoid specimen. Nasopharyngeal carcinoma was staged T2bN2M0. He was treated with concurrent chemoradiotherapy and 9-month course of anti tuberculosis treatment. He recovered and remained symptom free year after treatment.CONCLUSION: /strongNasopharyngeal carcinoma (NPC) and tuberculosis (TB) are both very common diseases in Sabah, East Malaysia. However, it is very rare that both diseases present at the same time and same anatomical area in a patient. Diagnosis can be very challenging and confusing. Multidisciplinary consultations are warranted for appropriate treatment. Combined anti-tuberculosis treatment and concurrent chemoradiotherapy may be appropriate and effective./p

Mandibular metastasis from nasopharyngeal carcinoma

@#<p style="text-align: justify;"><strong>OBJECTIVE</strong>: To describe a case of mandibular metastasis from nasopharyngeal carcinoma and review the literature.</p> <p style="text-align: justify;"><strong>METHODS</strong>: <br /><strong>Design</strong>: Case Report<br /><strong>Setting</strong>: Tertiary Public University Hospital<br /><strong>Patient</strong>: One<br /><br /><strong>RESULT</strong>: A 42-year-old Malay gentleman underwent concurrent chemoradiotherapy (CCRT) for T4N2M0 (Stage IVa) nasopharyngeal carcinoma (NPC) non-keratinizing type (WHO II). Upon completion of CCRT, he developed metastasis to the left body of the mandible that increased in size despite three cycles of adjuvant intravenous chemotherapy. Hemi-mandibulectomy was deferred due to recent irradiation and a further 15 fractions of boost radiotherapy reduced the mandibular metastasis in size but it has remained the same after six months follow up.</p> <p style="text-align: justify;"><strong>CONCLUSION</strong>: Nasopharyngeal carcinoma (NPC) is a common malignancy in Oriental Asia and the South East Asian regions. It has the highest rates of nodal and distant metastases among all head and neck cancers. Distant metastasis to bone is common but we could find no previous report of mandibular bone involvement in the literature. Radiotherapy remains the main treatment modality and combination with chemotherapy has been shown to improve survival of patients. There are studies on nasopharyngeal carcinoma tumour markers for diagnosis and disease process follow up but these are still inconclusive.</p>