Singapore Med J 2014; 55(5): e82-e84; http://dx.doi.org/10.11622/smedj.2013214
Dural metastasis of nasopharyngeal carcinoma: rare, but worth considering
Kuo CL, Ho DM, Ho CY
Correspondence: Dr Ching-Yin Ho, cyho@vghtpe.gov.tw
ABSTRACT
Metastasis of nasopharyngeal carcinoma (NPC) to the dura, an extremely rare condition, can be symptomatically silent and mistaken for a benign entity radiographically. Missed diagnosis can lead to serious consequences or prove immediately fatal. We report a woman with dural metastasis of NPC that mimicked a meningioma on radiography. Craniectomy with tumour resection was performed due to rapid progression from the onset of symptoms to disability. The patient was still alive two years after surgery. This case emphasises the need to keep in mind the possibility of dural metastasis of NPC in patients with abnormal imaging features. This would not only avoid wrong and optimistic diagnosis, but also allow for appropriate treatment in a timely manner. To our knowledge, this is the first report of metastasis of NPC to the dura. We provide detailed information on the neoplastic lesion, which masqueraded as a benign entity and caused potentially fatal consequences.
Keywords: carcinoma, dura mater, meningioma, metastasis, nasopharyngeal
Singapore Med J 2014; 55(5): e82-e84; http://dx.doi.org/10.11622/smedj.2013214
REFERENCES
1. Kuo CL, Wang MC, Chu CH, Shiao AS. New therapeutic strategy for treating otitis media with effusion in postirradiated nasopharyngeal carcinoma patients. J Chin Med Assoc 2012; 75:329-34. http://dx.doi.org/10.1016/j.jcma.2012.04.016 |
|
2. Ho SY, Wang YJ, Huang PC, et al. Evaluation of the associations between the single nucleotide polymorphisms of the promoter region of the tumor necrosis factor-alpha gene and nasopharyngeal carcinoma. J Chin Med Assoc 2006; 69:351-7. http://dx.doi.org/10.1016/S1726-4901(09)70272-2 |
|
3. Ahmad A, Stefani S. Distant metastases of nasopharyngeal carcinoma: a study of 256 male patients. J Surg Oncol 1986; 33:194-7. http://dx.doi.org/10.1002/jso.2930330310 |
|
4. Tagle P, Villanueva P, Torrealba G, Huete I. Intracranial metastasis or meningioma? An uncommon clinical diagnostic dilemma. Surg Neurol 2002; 58:241-5. http://dx.doi.org/10.1016/S0090-3019(02)00831-5 |
|
5. Lu H, Peng L, Yuan X, et al. Concurrent chemoradiotherapy in locally advanced nasopharyngeal carcinoma: a treatment paradigm also applicable to patients in Southeast Asia. Cancer Treat Rev 2009; 35:345-53. http://dx.doi.org/10.1016/j.ctrv.2009.01.002 |
|
6. Westphal M, Heese O, de Wit M. Intracranial metastases: therapeutic options. Ann Oncol 2003; 14 Suppl 3:iii4-10. http://dx.doi.org/10.1093/annonc/mdg741 |
|
7. Laigle-Donadey F, Taillibert S, Mokhtari K, Hildebrand J, Delattre JY. Dural metastases. J Neurooncol 2005; 75:57-61. http://dx.doi.org/10.1007/s11060-004-8098-1 |
|
8. Nayak L, Abrey LE, Iwamoto FM. Intracranial dural metastases. Cancer 2009; 115:1947-53. http://dx.doi.org/10.1002/cncr.24203 |
|
9. Nakamura M, Roser F, Mirzai S, et al. Meningiomas of the internal auditory canal. Neurosurgery 2004; 55:119-27; discussion 127-8. http://dx.doi.org/10.1227/01.NEU.0000126887.55995.E7 |