title: Pediatric advanced stage nasopharyngeal carcinoma - case report.
abstract: OBJECTIVE
  Nasopharyngeal carcinoma is an extremely rare pediatric malignancy predominantly occurring in adolescent males. Its multifactorial pathogenesis is most strongly associated with the exposure to Epstein-Barr virus in genetically susceptible hosts. In younger patients, more aggressive biological behavior has been observed, although the overall survival is better compared to adults. Due to its rarity and nonspecific clinical presentation, the diagnosis in children is often delayed and misinterpreted.
  
  
  METHODS
  We report a case of a 16-year-old boy with stage IVB nasopharyngeal carcinoma. He presented with a painless palpable neck mass, nasal congestion and a history of occasional epistaxis and headaches. Four years after the completion of a multimodal treatment, the patient is in complete remission.
  
  
  CONCLUSIONS
  Although exceedingly rare, pediatricians should consider nasopharyngeal carcinoma in the differential diagnosis of palpable neck masses, especially in male adolescents. A multidisciplinary approach in the diagnosis, treatment, supportive care and follow-up is of utmost importance.
authors.affiliation: Department of Pediatrics, Clinical Hospital Centre Rijeka, Croatia. jelena.roganovic1@ri.t-com.hr.
authors.forename: Jelena
authors.initials: J
authors.lastname: Roganović
authors.affiliation: Department of Pediatrics, Clinical Hospital Centre Rijeka, Croatia.
authors.forename: Nuša
authors.initials: N
authors.lastname: Matijašić
authors.affiliation: National Cancer Institute, Aviano, Italy.
authors.forename: Maurizio
authors.initials: M
authors.lastname: Mascarin
mesh_terms: D000293:Adolescent; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D002277:Carcinoma; D002945:Cisplatin / Q000008:administration & dosage; D005472:Fluorouracil / Q000008:administration & dosage; D006801:Humans; D002955:Leucovorin / Q000008:administration & dosage; D008198:Lymph Nodes / Q000473:pathology*; D008207:Lymphatic Metastasis; D008297:Male; D000077274:Nasopharyngeal Carcinoma; D009303:Nasopharyngeal Neoplasms / Q000175:diagnosis / Q000473:pathology* / Q000628:therapy; D009333:Neck; D020360:Neoadjuvant Therapy; D009367:Neoplasm Staging; D011878:Radiotherapy; D014057:Tomography, X-Ray Computed
chemical_list: D002945:Cisplatin; D002955:Leucovorin; D005472:Fluorouracil