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Shetal Shah, Qasiem Nasser, Roman Shinder, Bita Esmaeli; Clinical Presentation and Management of Nasopharyngeal Carcinoma Invading the Orbit. Invest. Ophthalmol. Vis. Sci. 2011;52(14):4538.
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Nasopharyngeal carcinoma is uncommon in America, but more common in Asia where it accounts for 18% of cancer in China. Nasopharyngeal carcinoma with orbital extension is a rare entity. We report the presentation, radiography, and treatment outcomes in 5 patients of different ethnicities with nasopharyngeal carcinoma with secondary orbital invasion.
Records of 5 patients evaluated for nasopharyngeal carcinoma with orbital invasion were reviewed.
All patients were men with a median age of 49 years (range 22-61, Table 1). Respective races were 2 White, 2 African American and 1 Asian. 4 patients had intra- and extraconal disease, while 1 patient had only extraconal orbital involvement. In 2 of the patients the orbit was involved at initial diagnosis while 3 patients presented with recurrent disease. The 3 patients that had recurrent disease were found to have distant metastasis at presentation. The diagnosis in all patients was confirmed by biopsy and histopathologic evaluation. 3 patients were treated with chemo-radiation, 1 patient received chemotherapy alone, and 1 patient did not receive treatment as he was lost to follow up. Median follow up was 12 months (range 0.5-37). At last follow up 2 patients were disease free, while 3 patients were alive with disease and represented the 3 patients with recurrent, metastatic disease. Visual acuity at last follow up ranged from 20/20 to no light perception.
Of the head and neck tumors that invade the orbit, nasopharyngeal carcinoma represents a very rare subtype. Past series of nasopharyngeal carcinoma with orbital invasion are few in number, and have only been published in the Asian literature, studying Asian patients who more commonly present with this malignancy. This series may be the largest to date from the United States and includes multiple ethnic groups. Chemo-radiation is the treatment of choice for local or metastatic disease. This concurrent therapy allows patients the chance to attain a disease free state without orbital exenteration as evidenced in patient #1.
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