Young nasopharyngeal carcinoma: a review of an 8-year experience in the East Coast Malaysia Hospital

Abstract

Abstract Introduction Nasopharyngeal carcinoma (NPC) is among the most common head and neck malignancies seen among adults in Malaysia. It is the third most common cancer in males after colorectal and lung cancers. Even though it has bimodal peak distribution, young NPC is a rare occurrence. It accounts for less than 1% of all paediatric cancers. Objective The objective of this study was to describe the 8-year experience with young NPC in the year 2003 until 2010 in a tertiary centre in East Coast Malaysia Hospital. Method Twenty-four young NPC cases confirmed by histopathology and undergoing treatment in a tertiary centre in East Coast Malaysia Hospital between 2003 and 2010 were retrospectively reviewed. We studied NPC incidence observed during that period, focusing on the age and sex distribution and the ethnic background of patients. We also analysed the most prevalent signs and symptoms and staging of the NPC patients at first presentation, which include neck swelling, ear symptoms, nasal symptoms and other miscellaneous symptoms. Results Presentation was predominant in the Malay population, with age peaking between 16 and 20 years. Most patients were male (70.8%). The main presenting symptoms were neck mass (70.9%), unilateral nasal obstruction (33.3%), epistaxis (29.2%) and other miscellaneous complaints (20.9%), including headache, diplopia and facial paraesthesia. In all, 25% of patients had cranial nerve involvements either isolated or a combination of cranial nerves 2, 3, 4, 5, or 6. Stage I, II, III and IV patients accounted for 0, 4.2, 12.5 and 83.3%, respectively. Majority (91.7%) had WHO type 3 NPC (undifferentiated carcinoma). Conclusion Results from our series are comparable to those reported by other centres. A majority of the patients were diagnosed late and at the advanced stage. The TMN staging was a relevant prognostic factor.