Pediatric Nasopharyngeal Cancer: Case Report and Review of the Literature

Pediatric Nasopharyngeal Carcinoma as Seen on 18F-FDG PET/CT

Pediatric nasopharyngeal carcinoma is a rare malignancy strongly associated with Epstein-Barr virus infection. Patients typically present with non-specific symptoms of epistaxis or serous otitis from eustachian tube obstruction and therefore diagnosis is often delayed. We present a case of a previously healthy 17 year old female who initially complained of migraines which was resistant to oral medication. Symptoms progressed and she saw a dental surgeon for concern of a dental infection and was prescribed antibiotics with no relief. Her symptoms continued to progress until an otolaryngologist visualized a large mass along the floor of the left nasal cavity. Subsequent imaging showed a large mass in the posterior left nasal cavity and biopsy was consistent with nasopharyngeal carcinoma.

Evaluation and Management of Pediatric Neck Masses: An Otolaryngology Perspective

Most pediatric neck masses encountered in primary care are benign, reactive lymph nodes that originate from common pediatric viral processes. In a pediatric otolaryngology practice, more unusual pathologies are encountered, such as embryologic anomalies, vascular lesions, or neoplasms. Lesions that are larger or that have concerning features will ultimately need imaging and excisional biopsy for histopathologic confirmation of the diagnosis. A sound clinician understanding of anatomic neck spaces and common etiologies of pediatric neck masses can greatly reduce nonessential testing, cost, delay in treatment, and parental angst.