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Article: Unusual endocrine presentations of nasopharyngeal carcinoma

TitleUnusual endocrine presentations of nasopharyngeal carcinoma
Authors
Keywordsbone metastases
ectopic ACTH syndrome
Epstein- Barr virus
nasopharyngeal carcinoma
Issue Date1996
PublisherJohn Wiley & Sons, Inc. The Journal's web site is located at http://www3.interscience.wiley.com/cgi-bin/jhome/28741
Citation
Cancer, 1996, v. 77 n. 10, p. 1967-1972 How to Cite?
AbstractBACKGROUND. Nasopharyngeal carcinoma is endemic in Southern China and the majority of patients present with local symptoms due to the tumor. METHODS. This report describes two unusual cases of occult nasopharyngeal carcinoma in which the patients initially presented with endocrine manifestations. RESULTS. The first patient presented with Cushing's syndrome secondary to ectopic adrenocorticotropic hormone (ACTH) production. Nasolaryngoscopy showed a growth in the left nasal fossa and biopsy revealed a poorly differentiated nasopharyngeal carcinoma that exhibited positive immunostaining for ACTH. The second patient presented with a 10-month history of bone pain over both lower limbs. She was normocalcemic but her serum alkaline phosphatase was markedly elevated. A bone biopsy showed both osteoclastic and osteoblastic activity with widespread fibrosis suggestive of Paget's disease. Three months later, she developed third cranial nerve palsy. Computed tomography investigation revealed a soft tissue mass filling the sphenoid and ethmoid sinuses. Biopsy showed a poorly differentiated nasopharyngeal carcinoma. The bone biopsy was reviewed and immunohistochemistry demonstrated the presence of cells positive for the epithelial marker AE1/3 within the fibrous stroma. Radio-labeled in situ hybridization showed that Epstein-Barr virus early RNA was present in these tumor cells and the bone lesions were in fact metastases. CONCLUSIONS. Nasopharyngeal carcinoma can present with rather atypical symptoms that may lead to a delay in diagnosis. Therefore, in high risk populations, it is important to consider nasopharyngeal carcinoma as a possible primary tumor in patients with occult carcinomas.
Persistent Identifierhttp://hdl.handle.net/10722/77994
ISSN
2023 Impact Factor: 6.1
2023 SCImago Journal Rankings: 2.887
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorTan, KCBen_HK
dc.contributor.authorNicholls, Jen_HK
dc.contributor.authorKung, AWCen_HK
dc.contributor.authorLeong, Len_HK
dc.contributor.authorLam, KSLen_HK
dc.date.accessioned2010-09-06T07:38:00Z-
dc.date.available2010-09-06T07:38:00Z-
dc.date.issued1996en_HK
dc.identifier.citationCancer, 1996, v. 77 n. 10, p. 1967-1972en_HK
dc.identifier.issn0008-543Xen_HK
dc.identifier.urihttp://hdl.handle.net/10722/77994-
dc.description.abstractBACKGROUND. Nasopharyngeal carcinoma is endemic in Southern China and the majority of patients present with local symptoms due to the tumor. METHODS. This report describes two unusual cases of occult nasopharyngeal carcinoma in which the patients initially presented with endocrine manifestations. RESULTS. The first patient presented with Cushing's syndrome secondary to ectopic adrenocorticotropic hormone (ACTH) production. Nasolaryngoscopy showed a growth in the left nasal fossa and biopsy revealed a poorly differentiated nasopharyngeal carcinoma that exhibited positive immunostaining for ACTH. The second patient presented with a 10-month history of bone pain over both lower limbs. She was normocalcemic but her serum alkaline phosphatase was markedly elevated. A bone biopsy showed both osteoclastic and osteoblastic activity with widespread fibrosis suggestive of Paget's disease. Three months later, she developed third cranial nerve palsy. Computed tomography investigation revealed a soft tissue mass filling the sphenoid and ethmoid sinuses. Biopsy showed a poorly differentiated nasopharyngeal carcinoma. The bone biopsy was reviewed and immunohistochemistry demonstrated the presence of cells positive for the epithelial marker AE1/3 within the fibrous stroma. Radio-labeled in situ hybridization showed that Epstein-Barr virus early RNA was present in these tumor cells and the bone lesions were in fact metastases. CONCLUSIONS. Nasopharyngeal carcinoma can present with rather atypical symptoms that may lead to a delay in diagnosis. Therefore, in high risk populations, it is important to consider nasopharyngeal carcinoma as a possible primary tumor in patients with occult carcinomas.en_HK
dc.languageengen_HK
dc.publisherJohn Wiley & Sons, Inc. The Journal's web site is located at http://www3.interscience.wiley.com/cgi-bin/jhome/28741en_HK
dc.relation.ispartofCanceren_HK
dc.rightsCancer. Copyright © John Wiley & Sons, Inc.en_HK
dc.subjectbone metastasesen_HK
dc.subjectectopic ACTH syndromeen_HK
dc.subjectEpstein- Barr virusen_HK
dc.subjectnasopharyngeal carcinomaen_HK
dc.subject.meshACTH Syndrome, Ectopic - complications - diagnosisen_HK
dc.subject.meshAdrenocorticotropic Hormone - analysisen_HK
dc.subject.meshBone Neoplasms - secondaryen_HK
dc.subject.meshCushing Syndrome - etiologyen_HK
dc.subject.meshDiagnosis, Differentialen_HK
dc.subject.meshFemaleen_HK
dc.subject.meshHerpesvirus 4, Human - isolation & purificationen_HK
dc.subject.meshHumansen_HK
dc.subject.meshMiddle Ageden_HK
dc.subject.meshNasopharyngeal Neoplasms - complications - diagnosisen_HK
dc.subject.meshOsteitis Deformans - diagnosisen_HK
dc.subject.meshOsteosclerosis - diagnosisen_HK
dc.titleUnusual endocrine presentations of nasopharyngeal carcinomaen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=0008-543X&volume=77&issue=10&spage=1967&epage=1972&date=1996&atitle=Unusual+endocrine+presentations+of+nasopharyngeal+carcinomaen_HK
dc.identifier.emailTan, KCB:kcbtan@hku.hken_HK
dc.identifier.emailNicholls, J:nicholls@pathology.hku.hken_HK
dc.identifier.emailKung, AWC:awckung@hku.hken_HK
dc.identifier.emailLam, KSL:ksllam@hku.hken_HK
dc.identifier.authorityTan, KCB=rp00402en_HK
dc.identifier.authorityNicholls, J=rp00364en_HK
dc.identifier.authorityKung, AWC=rp00368en_HK
dc.identifier.authorityLam, KSL=rp00343en_HK
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1002/(SICI)1097-0142(19960515)77:10<1967::AID-CNCR1>3.0.CO;2-Een_HK
dc.identifier.pmid8640657-
dc.identifier.scopuseid_2-s2.0-0029880192en_HK
dc.identifier.hkuros14142en_HK
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-0029880192&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume77en_HK
dc.identifier.issue10en_HK
dc.identifier.spage1967en_HK
dc.identifier.epage1972en_HK
dc.identifier.isiWOS:A1996UJ26200001-
dc.publisher.placeUnited Statesen_HK
dc.identifier.scopusauthoridTan, KCB=8082703100en_HK
dc.identifier.scopusauthoridNicholls, J=7201463077en_HK
dc.identifier.scopusauthoridKung, AWC=7102322339en_HK
dc.identifier.scopusauthoridLeong, L=7004323766en_HK
dc.identifier.scopusauthoridLam, KSL=8082870600en_HK
dc.identifier.issnl0008-543X-

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