Nasopharynx

Unusual nasopharyngeal foreign body: A hooked iron rod

July 5, 2012     Evelyne S. Diom, MBChB; Raymond Diouf, MBChB; El Hadji Malick Diop, MBChB
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Abstract

Foreign bodies lodged in the nasopharynx are rare. We report a case of an unusual foreign body in the nasopharynx: a hooked iron rod. The patient was a 5-year-old girl. The foreign body had to be removed under general anesthesia. To the best of our knowledge, there has been no similar published report of a hooked iron rod in the nasopharynx.

Diffuse large B-cell lymphoma of the nasopharynx

April 30, 2012     Lester D.R. Thompson, MD
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Diffuse large B-cell lymphoma accounts for more than 50% of all Waldeyer ring lymphomas, which in turn account for about 15% of all head and neck lymphomas and about 50% of all extranodal head and neck lymphomas.

AIDS-related primary Kaposi sarcoma of the nasopharynx

June 13, 2011     Fatih Çelenk, MD, Metin Yilmaz, MD, Korhan Asal, MD, Özgür Ekinci, MD, and Nil Tokgöz, MD
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Abstract

Primary nasopharyngeal Kaposi sarcoma is extremely rare, as only 1 case has been previously reported in the literature. We report a new case, which occurred in a 37-year-old man with a known history of acquired immune deficiency syndrome (AIDS). The patient presented with complaints of recurrent epistaxis and postnasal hemorrhage. Endoscopic examination detected a bluish, smooth, firm, nonpulsatile mass in the nasopharyngeal wall. Histopathologic findings on biopsy were consistent with Kaposi sarcoma. The tumor was successfully treated with radiotherapy. Kaposi sarcoma should be considered in the differential diagnosis of any AIDS patient who presents with recurrent unilateral nasal bleeding.

Nasopharyngeal dendritic cell sarcoma, not otherwise specified, in a 34-year-old man

June 13, 2011     William B. Horton, BS, David A. Joyner, MD, William P. Daley, MD, Karen T. Pitman, MD, and Majid A. Khan, MD
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Abstract

Dendritic cell sarcoma, not otherwise specified (NOS), is an entity that is poorly defined because of its rarity and poorly understood pathogenesis. It is characterized by positive immunohistochemical staining for S-100 and CD1a, along with an absence of cytoplasmic Birbeck granules on electron microscopy. We report the case of a surgically inaccessible nasopharyngeal dendritic cell sarcoma, NOS, in a 34-year-old man. Treatment with chemotherapy along with adjuvant radiation therapy was successful in decreasing the size of the nasopharyngeal mass, and the patient remained free of any evidence of recurrence nearly 5 years after treatment.

Cysts of the fossa of Rosenmüller: Report of two cases

July 31, 2010     Simon K.W. Lloyd, BSc(Hons), MPhil, FRCS(ORL-HNS), Riccardo A. Di Cuffa, DOHNS, MRCS, MRCGP, Felicity K. Seymour, MA, DOHNS, FRCS(ORL-HNS), Lloyd E. Savy, BSc(Hons), FRCR, and Henry R. Grant, FRCS
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Abstract

Cystic lesions of the nasopharynx are rare. Two cases of mucous retention cysts originating from the fossa of Rosenmüller are described, together with their characteristic radiologic appearance, which allows differentiation from other types of lesions in this region. The differential diagnosis and treatment options are discussed.

Solitary nasal schwannoma clinically presenting as an angiofibroma of the nasopharynx

June 30, 2010     S.C. Gupta, MS, Jain Sachin, MS, Saxena Savyasachi, MS, Jaiswal Ritesh, MBBS, Garg Neha, MBBS, and Himanshu P. Singh, MBBS
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Abstract

Benign schwannomas of the nasal cavity are rare. When they do occur, their clinical presentation is variable, and some are fairly vascular. We report the case of a 17-year-old boy who presented with epistaxis associated with a unilateral nasal mass that extended into the nasopharynx. The tumor was removed via a transpalatal approach. In most such cases, a clinical diagnosis of angiofibroma is made. In this case, however, histopathologic examination identified the lesion as a schwannoma.

Combined endoscopic and transoral resection of a primary nasopharyngeal paraganglioma

April 30, 2010     Eugene A. Chu, MD, William H. Westra, MD, Nafi Aygun, MD, and Nasir I. Bhatti, MD
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Abstract

We present what to the best of our knowledge is only the fourth case of a primary nasopharyngeal paraganglioma to be reported in the literature, and we describe a novel surgical approach to its removal. The patient was a 53-year-old woman who presented with a nasopharyngeal mass. A subtotal resection and biopsy of the mass identified it as a paraganglioma. The remainder of the tumor was completely excised via a combined transnasal endoscopic and transoral approach that allowed us to spare the palate. The total operating time was less than 90 minutes. Blood loss was estimated at 300 ml, and there were no intraoperative or postoperative complications. At follow-up 12 months later, endoscopic examination and imaging found no residual or recurrent tumor.

Dermoid of the nasopharynx: An unusual finding in an older child

March 31, 2010     Eyal Russo, MD, Hananya Vaknine, MD, and Yehudah Roth, MD

Radiologic findings after successful chemoradiation for nasopharyngeal cancer with skull base erosion

January 1, 2010     Federico Ampil, MD, Guillermo Sangster, MD, Glenn Mills, MD, Cherie Ann Nathan, MD, Timothy Lian, MD, and Andrew Hall, BS
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Abstract

Nonoperative management is generally accepted as a treatment strategy for nasopharyngeal cancer characterized by destruction of the skull base. Chemoradiotherapy is considered the standard of care in these cases. We report a case in which imaging studies documented the successful treatment of the patient's locally extensive nasopharyngeal carcinoma with this nonsurgical approach.

Synchronous presentation of extramedullary plasmacytoma in the nasopharynx and the larynx

October 31, 2009     Mete Iseri, MD, Murat Ozturk, MD, and S. Arif Ulubil, MD
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Abstract

Simultaneous extramedullary plasmacytoma of the nasopharynx and larynx is exceedingly rare; to the best of our knowledge, only 1 other case has been previously reported. We report a new case, which occurred in a 46-year-old woman. She was treated with a combination of surgery, radiotherapy, and chemotherapy. At 2 years of follow-up, no evidence of recurrence or progression to multiple myeloma was noted. We discuss the clinical features and treatment of plasma cell neoplasms in general and their three variants in particular.

A case of nasogastric tube perforation of the nasopharynx causing a fatal mediastinal complication

August 31, 2009     Ohad Ronen, MD and Nechama Uri, MD
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Abstract

Iatrogenic nasopharyngeal perforations secondary to improper nasogastric tube insertion probably occur more frequently than has been reported. Our review of the literature found very few cases. We report the case of a 79-year-old woman who died of mediastinal complications following the improper insertion of a nasogastric tube that resulted in a nasopharyngeal perforation. We also review the proper technique for inserting these tubes.

Nasopharyngeal neuroendocrine carcinoma: A case report

December 1, 2008     Ali Reza Mohebbi, MD, Ahmad Daneshi, MD, and Ali Reza Emami, MD
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Abstract

Neuroendocrine carcinoma is a type of neuroendocrine system neoplasm that occurs in organisms in which amine precursor uptake and decarboxylation (APUD) cells are uncommon. In the human body, the most common sites of neuroendocrine carcinoma are the gastrointestinal tract and the lungs. From a histologic standpoint, these tumors are identified by their positive reaction to silver stains and specific markers for neuroendocrine tissues, such as chromogranin A, synaptophysin, and neuron-specific enolase. In addition to local symptoms, these tumors may cause flushing, wheezing, and episodic diarrhea secondary to the release of vasoactive substances. Our medline search encompassing the 20-year period prior to 2003 found few cases of this type of tumor in the paranasal sinuses and nasal cavities and only 1 case of an isolated neuroendocrine carcinoma in the nasopharynx. We describe another case of an isolated nasopharyngeal neuroendocrine carcinoma, which we observed in a 74-year-old woman. We review the clinical presentation and the surgical and systemic treatment.

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