Incidentally-Discovered Extraosseous Cystic Nasopharyngeal Chordoma in a Papillary Thyroid Cancer Patient

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.

Prevalence of nasopharyngeal carcinoma among patients with nasopharyngeal mass in a Philippine tertiary training hospital

@#<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>

Large nasopharyngeal true teratoma in a Filipino newborn: A case report

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)