title: Whole-organ histopathological study of recurrent nasopharyngeal carcinoma.
abstract: OBJECTIVE
  To study the histopathological features of recurrent nasopharyngeal carcinoma and the accuracy of preoperative magnetic resonance imaging (MRI).
  
  
  METHODS
  Prospective.
  
  
  METHODS
  Whole-organ study of nasopharyngectomy specimens.
  
  
  RESULTS
  Between 2006 and 2009, 50 specimens were obtained after maxillary swing nasopharyngectomy and sent for whole-organ study. The tumors arose from the fossa of Rosenmüller (68%), posterior wall (18%), or roof of the nasopharynx (14%), and the majority (72%) took the form of an ulcerative tumor. The T-classifications of the recurrent tumors were: T1, 24%; T2, 48%; and T3, 28%. All the tumors appeared as islands of cancer cells separated by lymphoplasmacytic infiltrate and fibrosis. The tumor size measured by MRI correlated closely with that measured histologically, especially for the depth of invasion and parapharyngeal extension. For tumors with parapharyngeal extension, removal of the pharyngobasilar fascia was essential to ensure a clear margin on the surface of the petrosal internal carotid artery. None of the tumors showed invasion of the Eustachian tube.
  
  
  CONCLUSIONS
  Contrast MRI is accurate in assessing the local extent of recurrent nasopharyngeal carcinoma. During nasopharyngectomy, a radial resection margin of 15 mm should be taken with the underlying medial pterygoid muscle. For tumors with parapharyngeal extension, the pharyngobasilar fascia should be resected en bloc with the specimen.
  
  
  METHODS
  N/A.
authors.affiliation: Division of Head and Neck Surgery, Department of Surgery, University of Hong Kong Li Ka Shing Faculty of Medicine, Queen Mary Hospital, Hong Kong, China.
authors.forename: Jimmy Y W
authors.initials: JY
authors.lastname: Chan
authors.forename: Stanley T S
authors.initials: ST
authors.lastname: Wong
authors.forename: William I
authors.initials: WI
authors.lastname: Wei
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002277:Carcinoma; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D000077274:Nasopharyngeal Carcinoma; D009303:Nasopharyngeal Neoplasms / Q000473:pathology*; D009305:Nasopharynx / Q000473:pathology*; D009364:Neoplasm Recurrence, Local / Q000473:pathology*; D011446:Prospective Studies; D055815:Young Adult
keywords: Recurrent nasopharyngeal carcinoma; magnetic resonance imaging; maxillary swing; resection margins; whole-organ study