A Case of Nasopharyngeal Carcinoma Presenting as Middle Ear Tumor / 대한이비인후과학회지

Nasopharyngeal carcinoma (NPC) evolves most commonly from the pharyngeal recess posteromedial to the medial crura of the Eustachian tube opening in the nasopharynx. Therefore unilateral middle ear effusion with hearing loss is a common presenting symptom of NPC, and its presence in adult patients make physicians suspect NPC. Recently, we experienced a 72- year-old female patient with advanced NPC which invaded Eustachian tube and middle ear cavity. She had long standing chronic otitis media with large perforation of tympanic membrane. Because of tympanic membrane perforation, she did not have any Eustachian tube-related symptoms such as newly developing ear fullness or hearing loss and even the physician had overlooked the diagnosis of NPC. Her NPC was diagnosed at a very advanced stage after performing biopsy of middle ear tumor. This case report shows that NPC can present with very unusual findings like middle ear tumor.

The long term results of nasopharyngeal carcinoma treated by ~(60)Co external irradiation plus intracavitary radiotherapy using the high dose rate afterloading technique / 中华放射肿瘤学杂志

Purpose: The long term results and radiation sequelae of nasopharyngeal carcinoma treated by 60 Co external irradiation plus the high dose rate afterloading intracavity radiation (AIR) were analysed.Materials and Methods:From June 1981 to December 1988, 64 patients with nasopharyngeal cacinoma were treated by 60 Co external irradiation plus the high dose rate AIR. The AIR was given as a routine boost or for residual disease. The external irradiation dose varied from 55 to 70 Gy, whereas AIR dose ranged from 10 to 45 Gy. Results: All patients were followed up for mored than 5 years. The 5-year local control rate was 82.8%. The 5-year actuarial survival and disease free rates were 75.0%,68.8% respectively . 8 cases developed distant metastases, 6 cases recurred in the nasopharynx and/or neibouring structures and 1 case ocurred bone sarcoma of hard palate. The late radiation sequelae occured in 4 cases, 1 radiation necrosis of the bone in nasal cavity and 3 radiation perforations in hard and soft palate.Conclusion: We think that AIR for nasopharyngeal carcinoma is indicated for boosting the dose to the nasopharyngeal cavity with appropriated reduction in external irradiation dose ,and for residual disease after primary external radiotherpy. To reduce radiation sequelae applicator should be improved.