Sethu Thakachy Subha
University Putra Malaysia, Malaysia
Title: Recurrent nasopharyngeal carcinoma with axillary lymphnode metastases: A rare presentation
Biography
Biography: Sethu Thakachy Subha
Abstract
Nasopharyngeal carcinoma (NPC)representing about 0.7% of global burden of cancers where as NPC is the most common cancer of head and neck in Malaysia,South Eastern China ,Hong kong and Singapore.Nasopharyngeal carcinoma has typically metastases to cervical lymphnodes.Majority(>75%) of NPC patients have advanced locoregional disease with cervical metastases at the time of initial presentation. The common sites of distant metastases are bone,liver,lung and rarely metastases to axillary nodes.We report the rare presentation of recurrent NPC with axillary lympnode metastases.Our patient , 44 years old chinese gentleman who was diagnosed to have NPC with initial staging T2N3bM0 could not complete neoadjuvant chempradiotherapy due to severe oral mucositis.subsequent surveillance assessments were unremarkable and after 3 years he has presented with right axillary lymph nodes.Clinical examination revealed radiotherapy changes at the nasoharynx and absent cervical lymphadenopathy.Fine needle aspiration of nodes showed as metastatic carcinoma.CT scan showed obliteration of right fossa of Rosenmuller and axillary nodes.PET CT demonstarted right supraclacicular , axillary and mediatinal lymphnodes and patient has been subsequently referred for palliative chemotherapy.
Conclusion
This case illustartes the fact that ,eventhough NPC is highly radio and chemo sensitive ,these patients needs close follow up for early detection of recurrence and distant metastases.Despite the effectiveness of radiation and chemotherapy in the mangement of npc ,local or regional failure still occurs.Knowledge of potential mode of spread is not only vital to surgeons and also must be conveyed to patients for self examination.FDG-PET CT is better than CT in detecting residual or recurrent disease in NPC