Successful management of a recurrent hepatosplenic metastatic nasopharyngeal carcinoma in an adolescent boy: case report and review of literature

Abstract

A 16 year old boy presented with complaints of right sided nasal block for 4 months with right sided neck swelling for 2 months. Magnetic resonance imaging (MRI) of the head and neck done elsewhere revealed a nasopharyngeal mass with multiple necrotic nodes in the cervical, prevertebral and parapharyngeal region. Biopsy of the cervical lymph node was confirmative of undifferentiated nasopharyngeal carcinoma – non keratinizing type. Positron emission tomography–computed tomography (PET CT) done for metastatic evaluation revealed a fluorodeoxyglucose (FDG) avid mass with its epicenter in the right posterolateral wall of nasopharynx of size 44×40×45 mm (SUV max: 9.8) and FDG avid lymph nodes in right parotid, right upper and deep cervical, right supraclavicular and left upper deep cervical regions confirming advanced locoregional disease. He was treated 5 fluouracil and cisplatin and received 66Gys in 33 fractions to the nasopharynx and cervical lymph nodes. During the course of treatment, he developed radiation induced mucositis and had significant weight loss.