Whole‐organ histopathological study of recurrent nasopharyngeal carcinoma. (31st May 2013)

• Record Type: Journal Article
• Authors: Chan, Jimmy Y. W.; Wong, Stanley T. S.; Wei, William I.
• Is Part Of: Laryngoscope. Volume 124:Number 2(2014:Feb.)
• Page Start: 446
• Page End: 450
• Publication Date: 2013-05-31
• Subjects: Otolaryngology -- Periodicals; 617.51005
• DOI: 10.1002/lary.24218
• Languages: English
• ISSNs: 0023-852X

Abstract

<abstract abstract-type="main"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="lary24218-sec-0001" sec-type="section"> <title>Objectives/Hypothesis</title> <p>To study the histopathological features of recurrent nasopharyngeal carcinoma and the accuracy of preoperative magnetic resonance imaging (MRI).</p> </sec> <sec id="lary24218-sec-0002" sec-type="section"> <title>Study Design</title> <p>Prospective.</p> </sec> <sec id="lary24218-sec-0003" sec-type="section"> <title>Methods</title> <p>Whole‐organ study of nasopharyngectomy specimens.</p> </sec> <sec id="lary24218-sec-0004" sec-type="section"> <title>Results</title> <p>Between 2006 and 2009, 50 specimens were obtained after maxillary swing nasopharyngectomy and sent for whole‐organ study. The tumors arose from the fossa of Rosenmüller (68%), posterior wall (18%), or roof of the nasopharynx (14%), and the majority (72%) took the form of an ulcerative tumor. The T‐classifications of the recurrent tumors were: T1, 24%; T2, 48%; and T3, 28%. All the tumors appeared as islands of cancer cells separated by lymphoplasmacytic infiltrate and fibrosis. The tumor size measured by MRI correlated closely with that measured histologically, especially for the depth of invasion and parapharyngeal extension. For tumors with parapharyngeal extension, removal of the pharyngobasilar fascia was essential to ensure a clear margin on the surface of the petrosal internal carotid artery. None of the tumors showed invasion of the Eustachian tube.</p> </sec> <sec id="lary24218-sec-0005" sec-type="section"> <title>Conclusions</title> <p>Contrast MRI is accurate in assessing the local extent of recurrent nasopharyngeal carcinoma. During nasopharyngectomy, a radial resection margin of 15 mm should be taken with the underlying medial pterygoid muscle. For tumors with parapharyngeal extension, the pharyngobasilar fascia should be resected en bloc with the specimen.</p> </sec> <sec id="lary24218-sec-0006" sec-type="section"> <title>Level of Evidence</title> <p>N/A <italic>Laryngoscope</italic>, 124:446–450, 2014</p> </sec> </abstract>