A challenging presentation of invasive nasopharyngeal sarcomatoid carcinoma
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Department of Otolaryngology, Stockport NHS Foundation Trust, Stockport, UKIssue Date
2019
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Sarcomatoid carcinoma is a rare clinical entity, especially when presenting in the nasopharynx. We describe the first documented case of nasopharyngeal sarcomatoid carcinoma with intracranial extension in a 59-year-old Caucasian man presenting with severe bifrontal headache and diplopia, secondary to left abducens nerve palsy. We highlight some of the major diagnostic challenges and describe its unusual histological appearance. We outline the importance of a multidisciplinary approach to his management, which includes input from the medicine, neurosurgery, Ear, Nose and Throat (ENT), pathology, radiology, oncology and respiratory teams. In the context of limited evidence, we then describe the rationale to proceed with induction chemotherapy followed by concurrent chemoradiotherapy. Although there was a partial response to treatment, it was not sufficient enough to allow subsequent surgical clearance. The plan going forward is to palliate with chemotherapy as and when the disease progresses.Citation
Yao A, Saeed H, Udall G, Kaushik V, Lee LW. A challenging presentation of invasive nasopharyngeal sarcomatoid carcinoma. BMJ Case Rep. 2019;12(7).Journal
BMJ Case ReportsDOI
10.1136/bcr-2018-226168PubMed ID
31289153Additional Links
https://dx.doi.org/10.1136/bcr-2018-226168Type
ArticleLanguage
enae974a485f413a2113503eed53cd6c53
10.1136/bcr-2018-226168
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