title: Recurrent nasopharyngeal carcinoma presenting as diffuse dermal lymphatic infiltration in the neck: three case reports.
abstract: BACKGROUND
  Any malignancy has the propensity to metastasize to skin. The frequency of skin metastases vary in different tumors and occur in about 0.7% to 10% of all patients diagnosed with cancer. It is rare in nasopharyngeal carcinoma.
  
  
  METHODS
  Three cases of relapsed nasopharyngeal carcinoma with diffuse dermal involvement were described. Their clinical presentation, results of investigations, and response to treatment were reviewed. Literature review of similar forms of presentation was done by means of a MEDLINE search.
  
  
  RESULTS
  At the time of dermal relapse, all three patients had a uniform clinical picture of facial, periorbital, and lip swelling associated with stridor and dysphagia. Histologic findings showed dermal infiltrates of malignant cells, and CT scan showed diffuse infiltration of the subcutaneous tissue. Despite chemotherapy, the clinical course was relentless.
  
  
  CONCLUSIONS
  This report describes a presentation of disease that is underdiagnosed and heightens awareness of oncologists to this form of recurrence in nasopharyngeal carcinoma.
authors: Department of Medical Oncology, National Cancer Centre, Singapore. dmolss@nccs.com.sg
authors: S S
authors: SS
authors: Leong
authors: E H
authors: EH
authors: Tan
authors: H S
authors: HS
authors: Khoo-Tan
authors: T L
authors: TL
authors: Yang
authors: J
authors: J
authors: Wee
authors: S H
authors: SH
authors: Tan
authors: W T
authors: WT
authors: Poh
authors: N G
authors: NG
authors: Tan
mesh_terms: D000328:Adult; D006801:Humans; D008297:Male; D008875:Middle Aged; D009303:Nasopharyngeal Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging; D014057:Tomography, X-Ray Computed