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

Authors

  • Varsha Ramesh Department of Pediatrics, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India
  • Latha M. Sneha Department of Pediatrics, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India
  • Sushruthan Muralitharan Department of Pathology, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India
  • Dhaarani Jayaraman Department of Pediatrics, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India

DOI:

https://doi.org/10.18203/2349-3291.ijcp20210136

Keywords:

Nasopharyngeal carcinoma, Metastatic relapse, Splenectomy, Conventional chemotherapy

Abstract

Nasopharyngeal carcinoma (NPC) is a rare tumor in pediatric age group and adolescents are the commonly affected age group. It generally presents as locoregionally advanced disease and 15-30% of them develop a recurrence or distant metastatic disease. The outcome of patients with recurrent metastatic nasopharyngeal carcinoma has been reported to be very poor, with a median overall survival of about 20 months. We present a case of adolescent boy who presented initially with locally advanced nasopharyngeal carcinoma, treated with local radiotherapy and cisplatin, 5 flurouracil and later presented with a recurrent metastatic disease in liver and spleen, within 2 months of completing treatment. He was managed with total splenectomy and paclitaxel and gemcitabine and he remains disease free for more than 18 months now. The case highlights that long term remission could be attained with conventional chemotherapy, combined with surgery in relapsed metastatic NPC even in a resource limited settings.

Metrics

Metrics Loading ...

Author Biographies

Varsha Ramesh, Department of Pediatrics, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India

Second  year  MD Pediatrics  Post graduate,

Department of Pediatrics

Latha M. Sneha, Department of Pediatrics, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India

Associate Professor

Division of Pediatric Hemato Oncology 

Department of pediatrics 

Sushruthan Muralitharan, Department of Pathology, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India

 Associate Professor, Department of Pathology

Dhaarani Jayaraman, Department of Pediatrics, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India

Assistant professor  Division of Pediatric Hemato Oncology

References

Cunningham MJ, Myers EN, Bluestone CD. Malignant tumours of the head and neck in children: a twenty year review. Int J Pediatr Otorhinolaryngol. 1987;13:279-92.

Downing NL, Wolden S, Wong P, Petrik DW, Hara W, Le QT. Comparison of treatment results between adult and juvenile nasopharyngeal carcinoma. Int J Radiat Oncol Biol Phys. 2009;75:1064-70.

Healy G. Malignant tumors of the head and neck in children: diagnosis and treatment. Otolaryngol Clin North Am. 1980;13:483-8.

Perri F, Bosso D, Buonerba C, Lorenzo GD, Scarpati GD. Locally advanced nasopharyngeal carcinoma: current and emerging treatment strategies. World J Clin Oncol. 2011;2:377-83.

Wei WI, Sham JS. Nasopharyngeal carcinoma. Lancet. 2005;365:2041-54.

Genova P, Brunetti F, Bequignon E, Landi F, Lizzi V, Esposito F, et al. Solitary splenic metastasis from nasopharyngeal carcinoma: a case report and systematic review of the literature. World J Surg Oncol. 2016;14:184.

Radhakrishnan V, Thulkar S, Karunanithi S, Tanveer N, Bakhshi S. Nasopharyngeal carcinoma with splenic and cystic liver metastases in a pediatric patient: 18F-FDG PET-CT findings. Pediatr Radiol. 2010;40(1):79-82.

Kraus MDFM, Vonderheide RH. The spleen as a diagnostic specimen. Cancer. 2001;91:2001-9.

Lee SS, Morgenstern L, Phillips EH, Hiatt JR, Margulies DR. Splenectomy for splenic metastases: a changing clinical spectrum. Am Surg. 2000;66:837-40.

Sauer J, Sobolewski K, Dommisch K. Splenic metastases—not a frequent problem, but an underestimate location of metastases: epidemiology and course. J Cancer Res Clin Oncol. 2009;135:667-71.

Piardi T, D’Adda F, Giampaoli F, Pulcini G, Lancini GP, Pouche A. Solitary metachronous splenic metastases: an evaluation of surgical treatment. J Exp Clin Cancer Res. 1999;18:575-8.

DeRenzo C, Lam C, Rodriguez-Galindo C, Rapkin L, Gottschalk S, Venkataramani R. Salvage regimens for pediatric patients with relapsed nasopharyngeal carcinoma. Pediatr Blood Cancer. 2019;66:27469.

Ma BBY, Lim WT, Goh BC, Hui EP, Lo KW, Pettinger A, et al. Antitumor activity of nivolumab in recurrent and metastatic nasopharyngeal carcinoma: an international, multicenter study of the Mayo Clinic phase 2 Consortium (NCI-9742). J Clin Oncol. 2018;36:1412-8.

Downloads

Published

2021-01-22

How to Cite

Ramesh, V., Sneha, L. M., Muralitharan, S., & Jayaraman, D. (2021). Successful management of a recurrent hepatosplenic metastatic nasopharyngeal carcinoma in an adolescent boy: case report and review of literature. International Journal of Contemporary Pediatrics, 8(2), 386–388. https://doi.org/10.18203/2349-3291.ijcp20210136

Issue

Section

Case Reports