Epipharyngeal tumors

From WikiLectures

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

Benign tumors[edit | edit source]

Juvenile angiofibroma
Nasopharyngeal angiofibroma - 2 - high mag.jpg

It is a polypoid tumor. It occurs mainly in men between the ages of 15 and 25. Most regress during puberty.


lIt grows either exophytically or inverted - locally aggressive


Nasopharyngeal cancer[edit | edit source]

Nasopharyngeal cancer is common in Southeast Asia. It is rare in Europe. It is 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 Isquamous cell ca with horn:
    • tendency to local spread (cranial base)
    • less often the formation of metastases (regional and remote)
    • lower chemo- and radiosensitivity
  • type II – little differentiated squamous cell ca without horns.
  • type III – undifferentiated ca.

Type ll and lll have similar biological properties:

  • characteristic lymphocyte infiltration ,
  • early regional metastases (cervical nodes - packets),
  • formation of distant metastases more often than in other head and neck tumors,
  • association with EBV infection (increased anti-EBV antibody titers),
  • highly chemo- and radiosensitive .

Clinical picture[edit | edit source]

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

Early symptoms[edit | edit source]

Late symptoms[edit | edit source]

Diagnostics[edit | edit source]

  • Rhinoepifaryngoscopy,
  • neck palpation,
  • biopsy ,
  • CT , MR - spread to the base of the skull,
  • USG - nodal finding,
  • Chest X- ray - lung metastases.

Therapy[edit | edit source]

Angiofibroma[edit | edit source]

  • Surgery - lateral rhinotomy,
  • Bleeding - AG supply vessels and their selective embolization.

Carcinoma[edit | edit source]

The main treatment modality is radiotherapy - primary tumor and cervical nodes bilaterally (even in patients with unproven cervical metastases electively).

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

Links[edit | edit source]

related articles[edit | edit source]

Resources[edit | edit source]

  • {{#switch: book

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  Incomplete publication citation. KLOZAR, Jan. Speciální otorinolaryngologie. Praha : Galén, 2005. 224 s. 1; 978-80-7262-438-6.

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  Incomplete article citation.  KLOZAR, Jan. 2005, year 2005, 

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  Incomplete site citation. KLOZAR, Jan. Galén, ©2005. 

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  Incomplete carrier citation. KLOZAR, Jan. Galén, ©2005. 

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  Incomplete database citation. Galén, ©2005. 

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  KLOZAR, Jan. Speciální otorinolaryngologie. Praha : Galén, 2005. 224 s. 1; 978-80-7262-438-6} }