title: Nasopharyngeal carcinoma with headaches as the main symptom: A potential diagnostic pitfall.
abstract: BACKGROUND
  The aim of this study was to investigate medical-related reasons for misdiagnosis of nasopharyngeal carcinoma. (NPC) patients presenting with headaches alone or accompanied by other symptoms.
  
  
  METHODS
  Two-hundred and nineteen NPC cases describing headaches as one of the initial symptoms during primary treatment were selected for this prospective study. Medical records were carefully collected and all data were summarized for final analyses.
  
  
  RESULTS
  Distributions of NPC stage in the patients were: Stage II, 1.4%; stage III, 46.6%; stage IVA, 36.1%; stage IVB, 7.7%; and stage IVC, 8.2%. The ratio of men to women was 2.42:1 (155/64 cases). The total misdiagnosis rate was 43.4%. Patients that only complained of headaches had the highest misdiagnosis rate of 86.4% (19/22 cases). The lowest misdiagnosis rate of 10.9% (5/46 cases) was observed in patients with both headaches and epistaxis. The misdiagnosis rate in rural hospitals was more than two times that in provincial hospitals. Neurosurgery departments had a 100% misdiagnosis rate.
  
  
  CONCLUSIONS
  Frequently, headaches are the only prominent symptom of NPC. Due to the various clinical manifestations, NPC patients encounter a high misdiagnosis rate, which leads to unsatisfactory treatment outcomes. Improved awareness of the various nonspecific symptoms of NPC by nonspecialist physicians will be a pivotal step in decreasing the misdiagnosis rate. Mini Abstract: The misdiagnosis rate of nasopharyngeal carcinoma (NPC) patients with headaches was 43.4%. Improved awareness of the various nonspecific symptoms of NPC is a pivotal step in decreasing the misdiagnosis rate.
authors.forename: Zhou-Xue
authors.initials: ZX
authors.lastname: Wu
authors.affiliation: Department of Oncology, Affiliated Hospital of Luzhou Medical College, Luzhou, Sichuan, China.
authors.forename: Li
authors.initials: L
authors.lastname: Xiang
authors.forename: Jin-Feng
authors.initials: JF
authors.lastname: Rong
authors.forename: Huai-Lin
authors.initials: HL
authors.lastname: He
authors.forename: Dan
authors.initials: D
authors.lastname: Li
mesh_terms: D000328:Adult; D000368:Aged; D002277:Carcinoma; D003951:Diagnostic Errors; D005260:Female; D006261:Headache / Q000150:complications / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000503:physiopathology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D000077274:Nasopharyngeal Carcinoma; D009303:Nasopharyngeal Neoplasms / Q000150:complications / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000503:physiopathology; D009367:Neoplasm Staging; D014057:Tomography, X-Ray Computed