Nasopharyngeal carcinoma

Abstract

Nasopharyngeal carcinoma is a tumour affecting the nasopharynx commonly arising from the fossa of Rosenmüller and less frequently the posterior wall and roof of the nasopharynx. It has a high incidence amongst the southern Chinese particularly those of the Guangdong Province, Hong Kong and Taiwan. The uniqueness of this tumour is that it has known multifactorial causes with interplay between genetic and environmental factors. The frequent clinical presentation of this disease is asymptomatic neck mass or unilateral ear fullness. Cranial neuropathy may also occur due to the close proximity of the nasopharynx to the base of skull. Nasal endoscopic examination usually reveals an exophytic mass in the nasopharynx or a non suspicious submucosal mass. In less than 10% of cases no mass can be discerned in the nasopharynx. The diagnosis is often confirmed by biopsy. There are three main histopathological subtypes of nasopharyngeal carcinoma; keratinizing squamous cell carcinoma, non keratinizing carcinoma and undifferentiated carcinoma (WHO classification). Treatment of this tumour is mainly radiotherapy or chemoradiotherapy depending on the tumour staging. Surgical treatment of patients with nasopharyngeal carcinoma has a role but with specific indications. In this chapter we review on the latest in nasopharyngeal carcinoma with regards to its pathophysiology and treatment.