Epipharyngeal Tumors

From WikiLectures

The most common tumors of the epipharynx include angiofibroma, carcinoma, malignant lymphoma. Other types of tumors are rare in the nasopharynx.

Benign tumors[edit | edit source]

Juvenile angiofibroma
Juvenil angiofibroma

It is a polypoidal tumor. It occurs mainly in "men" between 15-25 years. Most regress during puberty.

Searchtool right.svg For more information see Juvenile Angiofibroma.

It grows either exophytically or invertedly - locally aggressive.


Carcinoma of the nasopharynx[edit | edit source]

Carcinoma of the nasopharynx is common in Southeast Asia. It is rare in Europe. Probably related to EBV exposure, not related to alcohol and cigarette consumption (unlike other head and neck ca).

Histology[edit | edit source]

There are 3 types of nasopharyngeal cancer:

  • type I - spinycellular ca with keratinization:
    • tendency to "local spread" (cranial base),
    • less often the formation of metastases (regional and distant),
    • lower chemo- and radiosensitivity.
  • type II - poorly differentiated squamous cell carcinoma without keratinization.
  • type III - undifferentiated ca.

Types II and III have similar biological properties:

  • characteristic infiltration of lymphocytes,
  • early regional metastases' (neck nodes - packets),
  • formation of "distant" metastases "more often" than in other head and neck tumors,
  • association with EBV infection (increased titers of antibodies against EBV),
  • highly chemo- and radiosensitive.

Clinical picture[edit | edit source]

The first symptom is usually painless enlargement of the neck nodes (metastases).

Early symptoms[edit | edit source]

  • From obstruction of the Eustachian tube (blocking of the ear, tinnitus - the result of the chronic presence of secretions in the middle ear - otitis media chronica secretorica).
  • Nasal obstruction (often unilateral), epistaxis.

Late symptoms[edit | edit source]

Diagnostics[edit | edit source]

Therapy[edit | edit source]

Angiofibroma[edit | edit source]

  • "Surgery" – lateral rhinotomy,
  • Bleeding - AG of supplying vessels and their selective embolization.

Carcinoma[edit | edit source]

The main treatment modality is radiotherapy' - primary tumor and neck nodes bilaterally (also elective in patients with unproven neck metastases).

  • Carcinoma of the nasopharynx is associated with a high incidence of occult meta in the neck nodes!
  • Chemotherapy - neoadjuvant × concomitant - patients with advanced tumor (T3 and T4) and patients with neck metastases.

Links[edit | edit source]

Related Articles[edit | edit source]

Resources[edit | edit source]

  • KLOZAR, Jan. Speciální otorinolaryngologie. 1. edition. Galén, 2005. pp. 224. ISBN 80-7262-346-X.