neoplasms of nasopharynx

Neoplasms of nasopharynx

Dr T Balasubramanian

drtbalu's otolaryngology online

Types of nasopharyngeal tumors

0 Benign0 Malignant

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Benign tumors

0 Juvenile nasopharyngeal angiofibroma (commonest)0 Chondroma0 Dermoid0 Teratoma0 Hamartoma0 Epignathi0 Branchial cyst0 Rhabdomyoma0 Hemangioma0 Hemangiopericytoma0 Craniopharyngioma

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Chondroma

0 This neoplasm is cartilaginous in origin0 Occurs in two forms – solitary / multiple0 Commonly arises from basiocciput / basisphenoid

region0 Difficult to differentiate from its malignant

counterpart chondrosarcoma0 Overlying mucosa is intact and non ulcerating

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Teratoma

0 New growths derived from pleuripotent tissue0 It is composed of elements of all three germinal layers0 Also known as hairy polyp of nasopharynx0 Could be sessile / pedunculated0 Often seen protruding into the mouth0 Associated cranial anomalies – palatal fissures,

hemicrania, anencephaly0 Polyhydramnios is common due to impaired

swallowing

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Teratoma (contd)

0 Maternal serum alpha fetoprotein levels raised

0 May demonstrate cystic and solid areas in CT / MRI imaging

0 Areas of bone and tooth formation can be clearly seen in imaging

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Hamartoma

0 These are simple congenital malformations0 Components of this tumor are derived from local

tissue0 They appear as polypoidal masses0 They are firmer than inflammatory polypi0 Size ranges between 1-5 cms0 Tumor surface appears lobulated0 Histologically these tumors consist of proliferating

epithelial elements

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Hamartoma (contd)

0 Hamartomas don’t infiltrate surrounding tissues (this feature differentiates it from adenocarcinoma)

0 Ciliated lining surface epithelium invaginates into the stroma of the mass

0 Two types of hamatomas – epithelial & mesenchymal

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Craniopharyngeoma

0 This is a type of pituitary adenoma

0 This tumor is cystic in nature

0 Histologically benign in nature

0 May be sellar / suprasellar in its location

0 Cyst contains brownish fluid with refractile cholesterol crystals

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Choristoma

0 This is displacement of tissue during the course of its development causing it to appear in the neighboring organ

0 Could be considered as a misplaced anlage0 It is so expansile that it can fill up the whole

nasopharynx and may also extend up to the parapharyngeal space.

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JNA

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Nasopharyngeal carcinoma