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Skull Base 2002; 12(2): 087-092
DOI: 10.1055/s-2002-31576
CASE REPORT

Copyright © 2002 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA. Tel.: +1(212) 584-4662

Second Malignant Tumors After Treatment of Nasopharyngeal Carcinoma: Four Case Reports and Literature Review

James P. Malone, Roger J. Levin
  • Division of Otolaryngology-Head and Neck Surgery, PennState Milton S. Hershey Medical Center, The Pennsylvania State University, Hershey, Pennsylvania
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Publication History

Publication Date:
18 May 2004 (online)

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ABSTRACT

The purpose of this study was to identify the histopathology, location, and latency interval for the development of second malignant tumors (SMT) after successful treatment for nasopharyngeal carcinoma (NPC). Of 55 patients, four developed SMT after successful treatment of NPC in a single institutional series for an incidence of 7%. An additional 31 patients with SMT after treatment for NPC were identified from the literature. At minimum, all patients were treated with radiotherapy to the primary site. The histopathology of SMT included sarcoma (69%), squamous cell carcinoma (17%), adenocarcinoma (6%), meningioma (6%), and lymphoma (3%). SMT occurred at various sites in the head and neck, but most (51%) arose in the sinonasal cavity. For the entire group, the mean latency interval between treatment for NPC and the development of SMT was 11.8 years. These findings indicate that the development of SMT in patients achieving long-term survival after treatment for NPC may be radiation induced. Long-term follow-up for these patients is important to assess for this potentially late complication.

KEYWORDS

Nasopharyngeal carcinoma - second malignant tumors

REFERENCES

  • 1 Chan A T, Teo P M, Leung T W, Johnson P J. The role of chemotherapy in the management of nasopharyngeal carcinoma.  Cancer . 1988;  82 1003-1012
    PubMedSearch in Google Scholar
  • 2 Muir C S. Nasopharyngeal carcinoma in non-Chinese populations with special reference to South-east Asia and Africa.  Int J Cancer . 1971;  8 351-363
    PubMedSearch in Google Scholar
  • 3 Vasef M A, Ferlito A, Weiss L M. Nasopharyngeal carcinoma with emphasis on its relationship to Epstein-Barr virus.  Ann Otol Rhinol Laryngol . 1997;  106 348-356
    PubMedSearch in Google Scholar
  • 4 Al-Sarraf M, LeBlanc M, Giri P GS. Chemoradiotherapy versus radiotherapy in patients with advanced nasopharyngeal cancer: phase III randomized Intergroup Study 0099.  J Clin Oncol . 1998;  16 1310-1317
    CrossrefPubMedSearch in Google Scholar
  • 5 Kotwall C, Razack M S, Sako K, Rao U. Multiple primary cancers in squamous cell cancer of the head and neck.  J Surg Oncol . 1989;  40 97-99
    CrossrefPubMedSearch in Google Scholar
  • 6 Ingersoll L, Shiao W Y, Donaldson S. Nasopharyngeal carcinoma in the young: a combined M.D  Anderson and Stanford experience. Int J Radiat Oncol Biol Phys . 1990;  19 881-887
    PubMedSearch in Google Scholar
  • 7 Stein M E, Drumea K, Bernstein Z, Daoud C, Zarour M, Kuten A. Advanced nasopharyngeal carcinoma and radiation-induced meningioma in dizygotic twins-a rare case report.  Acta Oncologica . 1996;  35 761-762
    PubMedSearch in Google Scholar
  • 8 Wang E HM, Sekyi-Out A, O'Sullivan B, Bell R S. Management of long-term postirradiation periclavicular complications.  J Surg Oncol . 1992;  51 259-265
    PubMedSearch in Google Scholar
  • 9 Lee A WM, Law S CK, Ng S H. Retrospective analysis of nasopharyngeal carcinoma treated during 1976-1985; late complications following megavoltage radiation.  Br J Radiol . 1992;  65 918-928
    CrossrefPubMedSearch in Google Scholar
  • 10 Dickens P, Wei W E, Sham J ST. Osteosarcoma of the maxilla in Hong Kong Chinese postirradiation for nasopharyngeal carcinoma: a report of four cases.  Cancer . 1990;  66 1924-1926
    PubMedSearch in Google Scholar
  • 11 John A C, Busby E R, Jones P H. Long-term survival in nasopharyngeal carcinoma.  J Laryngol Otol . 1980;  94 1265-1275
    PubMedSearch in Google Scholar
  • 12 Ayan I, Altun M. Nasopharyngeal carcinoma in children: retrospective review of 50 patients.  Int J Radiat Oncol Biol Phys . 1996;  35 485-492
    CrossrefPubMedSearch in Google Scholar
  • 13 Sheen T-S, Wu C-T, Hsieh T, Hsu M-M. Postirradiation laryngeal osteosarcoma: case report and literature review.  Head Neck . 1997;  19 57-62
    CrossrefPubMedSearch in Google Scholar
  • 14 Ko J-Y, Chen C-L, Lui L T, Hsu M-M. Radiation-induced malignant fibrous histiocytoma in patients with nasopharyngeal carcinoma.  Arch Otolaryngol Head Neck Surg . 1996;  122 535-538
    PubMedSearch in Google Scholar
  • 15 Papavasiliou C, Kouvaris J, Athanasiadis P, Patrinou A, Deligeorgi H. Mandibular sarcoma as a second neoplasm following radiotherapy for a nasopharyngeal carcinoma in childhood (case report).  Radiother Oncol . 1987;  8 333-335
    PubMedSearch in Google Scholar
  • 16 Tan B C, Chia K B. Radiation induced cancer: a report of 10 cases.  Ann Acad Med Sing . 1981;  10 267-272
    PubMedSearch in Google Scholar
  • 17 Lin S K, How S W, Wang J T, Liu B Y, Chiang C P. Oral postradiation malignant fibrous histiocytoma: a clinicopathological study.  J Oral Pathol Med . 1994;  23 324-329
    PubMedSearch in Google Scholar
  • 18 Cooper J S, Scott C, Marcial V. The relationship of nasopharyngeal carcinomas and second independent malignancies based on the Radiation Therapy Oncology Group Experience.  Cancer . 1991;  67 1673-1677
    PubMedSearch in Google Scholar
  • 19 Huang S-C. Nasopharyngeal cancer: a review of 1605 patients treated radically with cobalt 60.  Int J Radiat Oncol Biol Phys. 1980;  7 713-716
    PubMedSearch in Google Scholar
  • 20 Modan B, Mart H, Baidatz D, Steinitz R, Levin S G. Radiation-induced head and neck tumors.  Lancet . 1974;  1 277-291
    PubMedSearch in Google Scholar
  • 21 Qian T-N, Huang Y-R, Gu X-Z. Radiation induced cancer.  Radiat Oncol Biol Phys . 1983;  9 1246
    PubMedSearch in Google Scholar
  • 22 Wang C-C, Chen M-L, Hsu K-H. Second malignant tumors in patients with nasopharyngeal carcinoma and their association with Epstein-Barr virus.  Int J Cancer . 2000;  87 228-231
    CrossrefPubMedSearch in Google Scholar