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Zerbani H, Sellal N, Harrak M, El Bakouri H, Amraoui S, El Hfid M. Paraneoplastic Dermatomyositis Revealing the Metastatic Progression of an Undifferentiated Nasopharyngeal Carcinoma: A Case Report From Northern Morocco. Cureus 2024; 16:e57172. [PMID: 38681337 PMCID: PMC11056227 DOI: 10.7759/cureus.57172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/29/2024] [Indexed: 05/01/2024] Open
Abstract
Dermatomyositis (DM) is an inflammatory disease of striated muscles and skin that can occur sporadically or rarely be associated with malignancy, thereby serving as a potential clinical indicator or harbinger of underlying cancer. Knowing the pathognomonic, clinical, and biological features of DM plays a pivotal role in its recognition. Its correlation with nasopharyngeal carcinoma (NPC) is particularly prevalent in regions where the incidence of NPC is notably high, underscoring the intricate interplay between immune dysregulation and oncogenesis. Specially, in the context of patients previously treated for NPC, the emergence of DM raises the clinical suspicion of metastatic progression or recurrence of the cancer. Thus, early recognition of DM-associated paraneoplastic syndromes can facilitate prompt intervention and optimize patient outcomes. We present a case of metastatic progression in a patient treated for NPC, revealed by the pathognomonic, clinical, and biological signs of DM.
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Affiliation(s)
- Hamza Zerbani
- Radiation Therapy Department, University Hospital of Tangier, Tangier, MAR
| | - Nabila Sellal
- Radiation Therapy Department, University Hospital of Tangier, Tangier, MAR
| | - Mariame Harrak
- Radiation Therapy Department, University Hospital of Tangier, Tangier, MAR
| | - Hajar El Bakouri
- Radiation Therapy Department, University Hospital of Tangier, Tangier, MAR
| | - Sami Amraoui
- Radiation Therapy Department, University Hospital of Tangier, Tangier, MAR
| | - Mohamed El Hfid
- Radiation Therapy Department, University Hospital of Tangier, Tangier, MAR
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Stewart KE, Zeidler M, Srinivasan D, Yeo JCL. Opsoclonus-myoclonus paraneoplastic syndrome in nasopharyngeal carcinoma. BMJ Case Rep 2022; 15:e250871. [PMID: 36288826 PMCID: PMC9615974 DOI: 10.1136/bcr-2022-250871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Nasopharyngeal carcinoma can present with epistaxis, cervical lymphadenopathy, audiological symptoms secondary to eustachian tube dysfunction, pain, or neurological symptoms from tumours directly invading the skull base. It is unusual for patients to present with indirect systemic manifestations. Paraneoplastic neurological syndrome can precede clinically overt malignancy by up to 5 years; therefore, a combination of thorough clinical, laboratory and radiological investigations is required to reach a diagnosis. Intravenous immunoglobulin and steroids might improve neurological symptoms initially and prevent irreversible neuronal damage, but treatment of the underlying cancer is important for long-term resolution. Our case adds to a small but growing body of literature related to anti-Ri antibodies, opsoclonus-myoclonus syndrome presentations, and is the first reported association of this combination with nasopharyngeal carcinoma.
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Affiliation(s)
- Kirsten E Stewart
- University of Dundee School of Medicine, Dundee, UK
- Department of Otolaryngology, NHS Fife, Kirkcaldy, UK
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Panandtigri S, Siaˡ NPX, Charkaouiˡ M, Benchakrounˡ N, Bouchbikaˡ Z, Jouhadiˡ H, Tawfiqˡ N, Sahraouiˡ S, Beniderˡ A. Paraneoplastic dermatomyositis revealing undifferentiated nasopharyngeal carcinoma at early stage: a case report. J Med Case Rep 2022; 16:3. [PMID: 34980241 PMCID: PMC8725533 DOI: 10.1186/s13256-021-03154-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Accepted: 10/18/2021] [Indexed: 11/10/2022] Open
Abstract
Context Dermatomyositis is a rare autoimmune disease characterized by noninfectious inflammatory damage of skin and predominant muscles in the belts. It is believed to be associated with about 1 in 1000 cases of nasopharyngeal carcinoma. This association has been described for locally advanced stages II and III nasopharyngeal carcinoma. It has rarely been described in the early stages (stage I). Case presentation A 65-year-old Moroccan patient residing in Casablanca, with no particular history was referred to the Mohamed VI Center for the treatment of cancers of the University Hospital Center IBN ROCHD in Casablanca, for treatment of nasopharyngeal cancer. He was admitted in poor general condition, performance status 3, with erythema on the face, neck, and extremities. The diagnosis of paraneoplastic dermatomyositis was made owing to progressive muscle weakness and elevation of muscle enzymes associated with the typical rash of the face and hands. He received corticosteroid therapy and then radiotherapy to the nasopharynx with good clinical outcome, disappearance of skin lesions, and recovery of muscle strength. Conclusions We report this case of dermatomyositis in early-stage nasopharyngeal carcinoma, which is a rarely described entity. Rapid treatment of dermatomyositis improved the patient’s quality of life and enabled him to support specific cancer treatments. This can be used as an element of early diagnosis and monitoring after treatment.
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Affiliation(s)
- Souleymane Panandtigri
- Center Mohamed VI for the Treatment of Cancers of the University Hospital Center IBN ROCHD Casablanca, Casablanca, Morocco.
| | - Nioka Pierre Xavier Siaˡ
- Center Mohamed VI for the Treatment of Cancers of the University Hospital Center IBN ROCHD Casablanca, Casablanca, Morocco
| | - Meryeme Charkaouiˡ
- Center Mohamed VI for the Treatment of Cancers of the University Hospital Center IBN ROCHD Casablanca, Casablanca, Morocco
| | - Nadia Benchakrounˡ
- Center Mohamed VI for the Treatment of Cancers of the University Hospital Center IBN ROCHD Casablanca, Casablanca, Morocco
| | - Zineb Bouchbikaˡ
- Center Mohamed VI for the Treatment of Cancers of the University Hospital Center IBN ROCHD Casablanca, Casablanca, Morocco
| | - Hassan Jouhadiˡ
- Center Mohamed VI for the Treatment of Cancers of the University Hospital Center IBN ROCHD Casablanca, Casablanca, Morocco
| | - Nezha Tawfiqˡ
- Center Mohamed VI for the Treatment of Cancers of the University Hospital Center IBN ROCHD Casablanca, Casablanca, Morocco
| | - Souha Sahraouiˡ
- Center Mohamed VI for the Treatment of Cancers of the University Hospital Center IBN ROCHD Casablanca, Casablanca, Morocco
| | - Abdellatif Beniderˡ
- Center Mohamed VI for the Treatment of Cancers of the University Hospital Center IBN ROCHD Casablanca, Casablanca, Morocco
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Irekeola AA, Shueb RH, E. A. R. ENS, Wada Y, Abdul Rahman Z, Ahmad S, Mohamud R, Mat Lazim N, Yean CY. Prevalence of Nasopharyngeal Carcinoma in Patients with Dermatomyositis: A Systematic Review and Meta-Analysis. Cancers (Basel) 2021; 13:cancers13081886. [PMID: 33919987 PMCID: PMC8071042 DOI: 10.3390/cancers13081886] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 03/25/2021] [Accepted: 04/03/2021] [Indexed: 01/02/2023] Open
Abstract
Simple Summary This first systematic review and meta-analysis on the prevalence of nasopharyngeal carcinoma in patients suffering dermatomyositis was necessitated by the absence of a true and reliable prevalence estimate necessary to adequately inform medical preparedness and decisions. Following a careful review of literature and data analyses, a prevalence of 3.3% was found. It is hoped that a clear knowledge of the actual prevalence of nasopharyngeal carcinoma in dermatomyositis patients would not only help sensitize clinicians and patients about the frequency of these disease conditions but would also enhance the adoption of precautions essential to mitigate their co-occurrence in patients. Abstract For more than 50 years, nasopharyngeal carcinoma (NPC) has been associated with dermatomyositis (DM), a rare idiopathic inflammatory disorder that mainly affects the skin and muscles. Although the association between these rare diseases is well-documented, the actual prevalence of NPC in DM patients remains unknown. Here, a systematic review and meta-analysis of published data was conducted in accordance with the guidelines of Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA). Electronic databases including PubMed, Scopus, ScienceDirect, and Google Scholar were searched without year or language restrictions for studies reporting the occurrence of NPC in DM patients. The study protocol was lodged with PROSPERO (CRD42021225335). A total of 95 studies covering 303 cases of NPC among 16,010 DM patients was included. Summary estimates were calculated using the random-effects model. The pooled prevalence of NPC in DM was 3.3% (95% CI, 2.5–4.3). When stratified according to study location, higher prevalence estimates were obtained for Hong Kong (36.5%), Malaysia (27.7%), and Singapore (11.9%). There was a predominance of cases among male DM patients compared with females, and most patients were aged 40 and above. Many of the NPC cases were found to be diagnosed after the diagnosis of DM. It is therefore pertinent to screen for NPC in DM patients, especially among older DM patients in the Asian region.
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Affiliation(s)
- Ahmad Adebayo Irekeola
- Department of Medical Microbiology and Parasitology, School of Medical Sciences, Health Campus, Universiti Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia; (A.A.I.); (E.N.S.E.A.R.); (Y.W.); (Z.A.R.); (C.Y.Y.)
- Microbiology Unit, Department of Biological Sciences, College of Natural and Applied Sciences, Summit University Offa, Offa PMB 4412, Nigeria
| | - Rafidah Hanim Shueb
- Department of Medical Microbiology and Parasitology, School of Medical Sciences, Health Campus, Universiti Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia; (A.A.I.); (E.N.S.E.A.R.); (Y.W.); (Z.A.R.); (C.Y.Y.)
- Institute for Research in Molecular Medicine (INFORMM), Universiti Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia
- Correspondence:
| | - Engku Nur Syafirah E. A. R.
- Department of Medical Microbiology and Parasitology, School of Medical Sciences, Health Campus, Universiti Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia; (A.A.I.); (E.N.S.E.A.R.); (Y.W.); (Z.A.R.); (C.Y.Y.)
| | - Yusuf Wada
- Department of Medical Microbiology and Parasitology, School of Medical Sciences, Health Campus, Universiti Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia; (A.A.I.); (E.N.S.E.A.R.); (Y.W.); (Z.A.R.); (C.Y.Y.)
- Department of Zoology, Faculty of Life Sciences, Ahmadu Bello University, Zaria 810211, Nigeria
| | - Zaidah Abdul Rahman
- Department of Medical Microbiology and Parasitology, School of Medical Sciences, Health Campus, Universiti Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia; (A.A.I.); (E.N.S.E.A.R.); (Y.W.); (Z.A.R.); (C.Y.Y.)
- Hospital Universiti Sains Malaysia, Universiti Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia
| | - Suhana Ahmad
- Department of Immunology, School of Medical Sciences, Health Campus, Universiti Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia; (S.A.); (R.M.)
| | - Rohimah Mohamud
- Department of Immunology, School of Medical Sciences, Health Campus, Universiti Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia; (S.A.); (R.M.)
| | - Norhafiza Mat Lazim
- Department of Otorhinolaryngology-Head and Neck Surgery, School of Medical Sciences, Health Campus, Universiti Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia;
| | - Chan Yean Yean
- Department of Medical Microbiology and Parasitology, School of Medical Sciences, Health Campus, Universiti Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia; (A.A.I.); (E.N.S.E.A.R.); (Y.W.); (Z.A.R.); (C.Y.Y.)
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Low QJ, Hon SA, Garry Siow PW, Lim TH, Lee RA, Tan YA, Cheo SW. Dermatomyositis and nasopharyngeal carcinoma. QJM 2020; 113:753-754. [PMID: 31995198 DOI: 10.1093/qjmed/hcaa014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- Q J Low
- Department of Internal Medicine, Hospital Sultanah Nora Ismail, Jalan Korma, Taman Soga, Batu Pahat, Johor 83000, Malaysia
| | - S A Hon
- Department of Internal Medicine, Hospital Sultanah Nora Ismail, Jalan Korma, Taman Soga, Batu Pahat, Johor 83000, Malaysia
| | - P W Garry Siow
- Department of Internal Medicine, Hospital Sultanah Nora Ismail, Jalan Korma, Taman Soga, Batu Pahat, Johor 83000, Malaysia
| | - T H Lim
- Department of Internal Medicine, Hospital Sultanah Nora Ismail, Jalan Korma, Taman Soga, Batu Pahat, Johor 83000, Malaysia
| | - R A Lee
- Department of Radiology, Hospital Sultanah Nora Ismail, Jalan Korma, Taman Soga, Batu Pahat, Johor 83000, Malaysia
| | - Y A Tan
- Department of Internal Medicine, Hospital Queen Elizabeth, Kota Kinabalu, Sabah 88300, Malaysia
| | - S W Cheo
- Department of Internal Medicine, Hospital Lahad Datu, Peti Bersurat 60065, Lahad Datu, Sabah 91110, Malaysia
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Chang L, Zhang L, Jia H, Nie Z, Zhang L. Malignancy in dermatomyositis: A retrospective paired case-control study of 202 patients from Central China. Medicine (Baltimore) 2020; 99:e21733. [PMID: 32846794 PMCID: PMC7447459 DOI: 10.1097/md.0000000000021733] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
Dermatomyositis (DM) is an idiopathic inflammatory myopathy that is closely related to malignant diseases. Our study aims to investigate the incidence and predictive factors for occurrence of malignancy among DM patients from Central China.We performed a retrospective, paired, case-control study of 736 DM patients admitted to the First Affiliated Hospital of Zhengzhou University between 2010 and 2017. We paired the 65 patients with malignancy with age-matched and sex-matched patients without malignancy in a ratio of 1:2. Two hundred two patients were finally enrolled and their clinical and laboratory data were collected.The incidence of malignancy in DM patients was 8.83% (65/736). Most malignancies were detected in the most recent 1 year before (9/65, 13.85%) or within 3 years after (40/65, 61.54%) the onset of DM. Males (35/65, 53.85%) and patients aged between 50 and 69 years (43/65, 66.15%) were prone to develop malignancies. Lung cancer (n = 11, 31.43%) was the most common malignancy in male patients, while for females, thyroid, breast and cervical cancer (n = 4 each, 13.33%) were more prevalent. Adenocarcinoma and squamous cell carcinoma (both 18/65, 27.69%) were the top two most common pathological types. Univariate analysis demonstrated that Gottron's sign (P = .02), dysphagia (P = .04), albumin (ALB) reduction (P = .003), aspartate aminotransferase (AST, P = .03), creatine kinase-MB (P = .02), absence of fever (P = .02), arthralgia (P = .04) and interstitial lung disease (ILD, P = .05) were closely related to the occurrence of malignancy. Multivariate analysis revealed the independent risk factors of ALB reduction (odds ratio = 1.546, P = .04) and the protective factor of ILD (odds ratio = 0.349, P = .003). There was no significant difference in the follow-up period between patients with and without ILD (P = .38).ALB reduction and the absence of ILD were the risk factors for malignancy in DM patients. The protective mechanism of ILD for DM patients needs further study.
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Affiliation(s)
- Lili Chang
- Department of Oncology, the Fourth Affiliated Hospital of Henan University of Science and Technology, Anyang Cancer Hospital, Anyang, Henan
- Department of Rheumatology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Lina Zhang
- Department of Breast Surgery, Tianjin Medical University Cancer Institute and Hospital, Tianjin
| | - Haiquan Jia
- Department of General Surgery, the Fourth Affiliated Hospital of Henan University of Science and Technology, Anyang Cancer Hospital, Anyang
| | - Zhiyong Nie
- Department of Oncology, the Fourth Affiliated Hospital of Henan University of Science and Technology, Anyang Cancer Hospital, Anyang, Henan
| | - Lei Zhang
- Department of Rheumatology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
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Sivakumar P, Palanive S, Gochait D, Hess O. Diagnostic challenges in a case of an isolated third nerve palsy. Am J Ophthalmol Case Rep 2020; 18:100585. [PMID: 32099933 PMCID: PMC7031130 DOI: 10.1016/j.ajoc.2020.100585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Accepted: 01/01/2020] [Indexed: 10/27/2022] Open
Abstract
Purpose Neuro-ophthalmic manifestations may be the first and sole presenting feature of a nasopharyngeal carcinoma. Peri-neural spread is an emerging phenomenon that explains the distant spread of tumour cells well beyond the local extent of invasion. This under recognized route of tumour spread often results in delayed diagnosis and reduced life expectancy. The authors report a case of an isolated third nerve palsy as the only initial manifestation of nasopharyngeal carcinoma and emphasize the need for a high index of suspicion. Observation The patient presented with left painful pupil involving complete third nerve palsy. Contrast enhanced imaging was initially deferred due to renal impairment. Plain MRI with MRA brain was normal. Hematology was suggestive of giant cell arteritis which is a rare but well documented cause of painful nerve palsies in the elderly. Unresponsiveness to steroids prompted contrast imaging with a reduced gadolinium dosing and hemodialysis backup which finally revealed a nasopharyngeal carcinoma. Conclusion and importance This report is the journey of a third nerve palsy from a clinical diagnosis of an aneurysm (pupil involving palsy) to a probable diagnosis of giant cell arteritis (based on hematology) and to a final diagnosis of nasopharyngeal carcinoma (based on contrast imaging and immunohistochemistry)Nasopharyngeal carcinoma can be successfully cured if detected early. This report highlights the various manifestations of nasopharyngeal carcinoma and challenges faced in diagnosing this elusive tumor.
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Bhardwaj S, Khasani S, Benasher D, Stein EG, Meghal T, Jacoby N, Huang YJ. Paraneoplastic Cerebellar Degeneration in Nasopharyngeal Carcinoma: a Unique Association. CEREBELLUM (LONDON, ENGLAND) 2019; 18:1126-1129. [PMID: 31161534 DOI: 10.1007/s12311-019-01045-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Paraneoplastic cerebellar degeneration (PCD) is a rare disorder that is associated with lung or gynecological malignancies and Hodgkin lymphoma. Neurologic symptoms are commonly the initial presenting sign leading to the diagnosis of an underlying malignancy. We are presenting an Asian male with progressive lower extremity weakness with EBV-positive nasopharyngeal carcinoma (NPC) and anti-Yo antibodies. Peculiarly, transient diffuse leptomeningeal enhancement is seen on MR imaging. This is the first report of PCD associated with NPC and thus illustrates that PCD embodies a boarder set of disease than previously described.
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Affiliation(s)
- S Bhardwaj
- Department of Internal Medicine (Relocated to New York University as Clinical Instructor and Hospitalist), Maimonides Medical Center, 4810 10th Avenue, Brooklyn, NY, 11219, USA.
| | - S Khasani
- Department of Neurology, Maimonides Medical Center, 4810 10th Avenue, Brooklyn, NY, 11219, USA
| | - D Benasher
- Department of Hematology and Oncology, Maimonides Medical Center, 4810 10th Avenue, Brooklyn, NY, 11219, USA
| | - E G Stein
- Department of Neuroradiology, Maimonides Medical Center, 4810 10th Avenue, Brooklyn, NY, 11219, USA
| | - T Meghal
- Department of Hematology and Oncology, Maimonides Medical Center, 4810 10th Avenue, Brooklyn, NY, 11219, USA
| | - N Jacoby
- Department of Neurology, Maimonides Medical Center, 4810 10th Avenue, Brooklyn, NY, 11219, USA
| | - Y J Huang
- Department of Hematology and Oncology, Maimonides Medical Center, 4810 10th Avenue, Brooklyn, NY, 11219, USA
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Ito T, Majima H, Ozawa T, Maeda M, Iwamoto S, Hirayama M, Azuma E. An Unusual Presentation of Nasopharyngeal Carcinoma as Lemierre Syndrome. AMERICAN JOURNAL OF CASE REPORTS 2019; 20:263-267. [PMID: 30814483 PMCID: PMC6441307 DOI: 10.12659/ajcr.913755] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Clinical presentation of nasopharyngeal carcinoma (NPC) is correlated with the extent of primary and nodal disease. Hence, depending on the anatomical structures affected, the clinical presentation varies accordingly, ranging from non-specific symptoms of epistaxis, unilateral nasal obstruction, and auditory complaints, to cranial nerve palsies. Nodal metastasis in the neck is a frequent clinical finding in nasopharyngeal carcinoma. CASE REPORT A female was admitted to the hospital because of fever and trismus with painful swelling in the right neck. Computed tomography (CT) revealed a mass in the nasopharynx with heterogeneous enhancement and multiple swollen lymph nodes in the corresponding neck. Initial biopsies of nasopharyngeal mass and lymph node of the neck revealed nonspecific lymphoid hyperplasia; we administered antibiotics with the provisional diagnosis of bacterial infection, including Lemierre syndrome that is typically defined by the constellation of septic internal jugular vein thrombophlebitis, pulmonary and other septic emboli, and sterile site bacterial infection. However, the patient was refractory to antibiotics over a month of treatments. The third biopsy of the throat lesion revealed NPC and bacterial cultures using the biopsy specimen were negative. She received intensity-modulated radiation therapy and chemotherapy for NPC stage II (TNM staging: T2N1M0). She never developed Lemierre syndrome-like symptoms after chemoradiotherapy. CONCLUSIONS We report a unique case of NPC presenting with Lemierre syndrome-like symptoms, including prior sore throat, trismus, painful swollen neck, and high fever. Since these symptoms have not been reported in NPC, we included NPC as a differential diagnosis.
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Affiliation(s)
- Tsuyoshi Ito
- Department of Pediatrics, Toyohashi Municipal Hospital, Toyohashi, Aichi, Japan
| | - Hisakazu Majima
- Department of Pediatrics, Toyohashi Municipal Hospital, Toyohashi, Aichi, Japan
| | - Taijiro Ozawa
- Department of Otolaryngology, Toyohashi Municipal Hospital, Toyohashi, Aichi, Japan
| | - Matsuyoshi Maeda
- Department of Pathology, Toyohashi Municipal Hospital, Toyohashi, Aichi, Japan
| | - Shotaro Iwamoto
- Department of Pediatrics, Mie University Graduate School of Medicine, Tsu, Mie, Japan
| | - Masahiro Hirayama
- Department of Pediatrics, Mie University Graduate School of Medicine, Tsu, Mie, Japan
| | - Eiichi Azuma
- Department of Clinical Engineering, Suzuka University of Medical Science, Suzuka, Mie, Japan
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Ng SY, Kongg MH, Yunus MRM. Paraneoplastic Neurological Disorder in Nasopharyngeal Carcinoma. Malays J Med Sci 2017; 24:113-116. [PMID: 28381934 DOI: 10.21315/mjms2017.24.1.12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2015] [Accepted: 06/19/2016] [Indexed: 10/20/2022] Open
Abstract
Paraneoplastic neurological disorder (PND) is a condition due to immune cross-reactivity between the tumour cells and the normal tissue, whereby the "onconeural" antibodies attack the normal host nervous system. It can present within weeks to months before or after the diagnosis of malignancies. Nasopharyngeal carcinoma is associated with paraneoplastic syndrome, for example, dermatomyositis, and rarely with a neurological disorder. We report on a case of nasopharyngeal carcinoma with probable PND. Otolaryngologists, oncologists and neurologists need to be aware of this condition in order to make an accurate diagnosis and to provide prompt treatment.
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Affiliation(s)
- Sze Yin Ng
- Department of Otorhinolaryngology, Head & Neck Surgery, UKM Medical Centre, Jalan Yaacob Latif, 56000 Cheras, Kuala Lumpur, Malaysia
| | - Min Han Kongg
- Department of Otorhinolaryngology, Head & Neck Surgery, UKM Medical Centre, Jalan Yaacob Latif, 56000 Cheras, Kuala Lumpur, Malaysia
| | - Mohd Razif Mohamad Yunus
- Department of Otorhinolaryngology, Head & Neck Surgery, UKM Medical Centre, Jalan Yaacob Latif, 56000 Cheras, Kuala Lumpur, Malaysia
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Paraneoplastic syndromes in patients with laryngeal neuroendocrine carcinomas: clinical manifestations and prognostic significance. Eur Arch Otorhinolaryngol 2014; 273:533-6. [DOI: 10.1007/s00405-014-3351-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2014] [Accepted: 10/20/2014] [Indexed: 12/15/2022]
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Teoh JW, Yunus RM, Hassan F, Ghazali N, Abidin ZAZ. Nasopharyngeal carcinoma in dermatomyositis patients: A 10-year retrospective review in Hospital Selayang, Malaysia. Rep Pract Oncol Radiother 2014; 19:332-6. [PMID: 25184058 DOI: 10.1016/j.rpor.2014.02.005] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2012] [Revised: 10/10/2013] [Accepted: 02/27/2014] [Indexed: 11/30/2022] Open
Abstract
AIM The objective of our review is to investigate the association between dermatomyositis patients and nasopharyngeal carcinoma (NPC) together with the clinical presentation of the patients and their management in otorhinolaryngology. BACKGROUND NPC is a malignant disease with good prognosis on early diagnosis. However, the relationship between the dermatomyositis and NPC and its management is not well defined. MATERIALS AND METHODS A 10-year retrospective review of case records of 21 dermatomyositis patients seen in Otorhinolaryngology Department of Hospital Selayang from January 2000 to November 2010. RESULTS These patients ranged from 19 to 74 years old and a total of 8 (38%) out of 21 adults with dermatomyositis were detected to have malignancy. Five out of 8 patients had NPC (62.5%). The mean age of patients with NPC and dermatomyositis was 48 years. NPC is diagnosed in 4 out of 5 patients (80%) in the first year of diagnosis of dermatomyositis. The clinical findings of the examination of nasopharynx ranged from hyperemia to exophytic nasopharyngeal mass. Histologically, it is only related to NPC of WHO types II and III. CONCLUSIONS There is a strong relationship between dermatomyositis and malignancy, especially NPC. Clinicians should have a high index of suspicion for malignancy in all dermatomyositis patients. Rigid nasoendoscopies and biopsies, serum Epstein-Barr viral capsid IgA antibody and imaging studies are helpful in detecting NPC in dermatomyositis patients.
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Affiliation(s)
- J W Teoh
- Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia ; Selayang Hospital, Kuala Lumpur, Malaysia
| | - Razif M Yunus
- Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia
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Abstract
Cancer of the nasopharynx is an uncommon malignancy in France (incidence = 0.5/year/100,000 men) but is endemic in areas like in South-East Asia. Exclusive radiation therapy used to be the standard and results in local control rates for T3-T4 tumors around 50-75 %. Intensity-modulated radiotherapy (IMRT) improves tumor coverage with a sparing of organs at risk and has to be privileged. Concurrent chemotherapy with IMRT achieved significant survival benefice with 5-year overall survival above 75 %. Concurrent radiochemotherapy with platinum is the most frequent scheme but induction and adjuvant chemotherapies are discussed to reduce distant failure: studies are currently ongoing. Follow-up aims to detect early local failures with a chance of cure and to manage long-term toxicities.
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Yuste-Chaves M, Unamuno-Pérez P. Alertas cutáneas en malignidades sistémicas (parte I). ACTAS DERMO-SIFILIOGRAFICAS 2013. [DOI: 10.1016/j.ad.2012.03.004] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Yuste-Chaves M, Unamuno-Pérez P. Cutaneous alerts in systemic malignancy: part I. ACTAS DERMO-SIFILIOGRAFICAS 2013; 104:285-98. [PMID: 23578547 DOI: 10.1016/j.adengl.2012.03.027] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2011] [Accepted: 03/13/2012] [Indexed: 12/16/2022] Open
Abstract
The aim of this review is to familiarize dermatologists and clinicians in general with cutaneous signs and symptoms that can help lead to an early diagnosis of an underlying malignancy. Because the skin is one of the most accessible organs, it should never be overlooked in systemic disease. Examination of the skin has the advantage of revealing important information about the patient's condition without requiring the use of invasive techniques. In the literature, most discussions of cutaneous manifestations of internal malignancy refer to classic paraneoplastic syndromes, but a wide variety of skin conditions, while not strictly paraneoplastic, can, in certain contexts, indicate the presence of malignancy or an increased risk of developing cancer later in life. In this review, various skin conditions that can signal malignancy or increased cancer risk are presented in randomly ordered groups based on clinical morphology. Conditions with multiple signs and symptoms have been classified on the basis of their most characteristic feature.
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Affiliation(s)
- M Yuste-Chaves
- Servicio de Dermatología, Hospital Universitario de Salamanca, Salamanca, Spain.
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Chakroun A, Guigay J, Lusinchi A, Marandas P, Janot F, Hartl D. Paraneoplastic dermatomyositis accompanying nasopharyngeal carcinoma: Diagnosis, treatment and prognosis. Eur Ann Otorhinolaryngol Head Neck Dis 2011; 128:127-31. [DOI: 10.1016/j.anorl.2010.10.007] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2010] [Accepted: 10/31/2010] [Indexed: 10/18/2022]
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Suárez C, Rodrigo JP, Rinaldo A, Langendijk JA, Shaha AR, Ferlito A. Current treatment options for recurrent nasopharyngeal cancer. Eur Arch Otorhinolaryngol 2010; 267:1811-24. [PMID: 20865269 PMCID: PMC2966947 DOI: 10.1007/s00405-010-1385-x] [Citation(s) in RCA: 100] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2010] [Accepted: 08/27/2010] [Indexed: 11/28/2022]
Abstract
Loco-regional control rate of nasopharyngeal carcinoma (NPC) has improved significantly in the past decade. However, local recurrence still represents a major cause of mortality and morbidity in advanced stages, and management of local failure remains a challenging issue in NPC. The best salvage treatment for local recurrent NPC remains to be determined. The options include brachytherapy, external radiotherapy, stereotactic radiosurgery, and nasopharyngectomy, either alone or in different combinations. In this article we will discuss the different options for salvage of locally recurrent NPC. Retreatment of locally recurrent NPC using radiotherapy, alone or in combination with other treatment modalities, as well as surgery, can result in long-term local control and survival in a substantial proportion of patients. For small-volume recurrent tumors (T1–T2) treated with external radiotherapy, brachytherapy or stereotactic radiosurgery, comparable results to those obtained with surgery have been reported. In contrast, treatment results of advanced-stage locally recurrent NPC are generally more satisfactory with surgery (with or without postoperative radiotherapy) than with reirradiation.
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Affiliation(s)
- Carlos Suárez
- Instituto Universitario de Oncología del Principado de Asturias, Oviedo, Spain
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Toro C, Rinaldo A, Silver CE, Politi M, Ferlito A. Paraneoplastic syndromes in patients with oral cancer. Oral Oncol 2009; 46:14-8. [PMID: 19932048 DOI: 10.1016/j.oraloncology.2009.09.007] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2009] [Revised: 09/29/2009] [Accepted: 09/30/2009] [Indexed: 12/15/2022]
Abstract
The diagnosis of a paraneoplastic syndrome (PNS) may precede, follow or be concurrent with the diagnosis of a malignant tumor. There is increasing knowledge of association between PNS and head and neck cancers, but the relationship between oral cancer and paraneoplastic disease has not been previously investigated. PNS associated with head and neck cancer can be divided into six main groups: endocrine, cutaneous or dermatologic, hematologic, osteoarticular or rheumatologic, neurologic, and ocular syndromes. We have comprehensively reviewed the literature to evaluate the incidence of occurrence of PNS with oral cancer, and conclude that only endocrine and dermatologic PNS have been associated with oral cancer. Humoral hypercalcemia is the most frequent PNS related to oral cancer, and has a negative prognostic significance. Dermatologic PNS are less common, but when they occur, they may precede the diagnosis of the oral tumor. Awareness of these conditions is important for clinicians who deal with cancer.
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Affiliation(s)
- C Toro
- Department of Surgical Sciences, Maxillofacial Surgery Clinic, University-Hospital of Udine, Udine, Italy.
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