title: Nasopharyngeal carcinoma with mastoid recurrence after concurrent chemoradiotherapy masquerading as acute otomastoiditis.
abstract: Nasopharyngeal cancer (NPC) with mastoid recurrence is extraordinarily rare, and its development is thought to involve the Eustachian tube. We herein report a case of NPC with mastoid recurrence masquerading as acute otomastoiditis with facial paralysis in a 60-year-old man 44 months after concurrent chemoradiotherapy. The diagnosis was confirmed by exploratory tympanomastoidectomy with biopsy and Epstein-Barr-encoding region (EBER) in situ hybridization. Distant liver metastasis was detected simultaneously, and the patient underwent salvage treatment. He died 15 months later. Despite the rarity of mastoid recurrence, clinicians should be vigilant in the differential diagnosis of mastoiditis in patients with NPC after radiotherapy. Tumor biopsy and EBER in situ hybridization can aid in the accurate diagnosis of this uncommon condition.
authors.affiliation: Department of Otolaryngology & Head and Neck Surgery, Chang Gung Memorial Hospital and Chang Gung University, Linkuo, Taiwan.
authors.forename: Chih-Yu
authors.initials: CY
authors.lastname: Hu
authors.affiliation: Department of Otolaryngology & Head and Neck Surgery, Chang Gung Memorial Hospital and Chang Gung University, Linkuo, Taiwan.
authors.forename: Shiang-Fu
authors.initials: SF
authors.lastname: Huang
authors.affiliation: Department of Pediatrics, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan; School of Medicine, College of Medicine, Fu Jen Catholic University, New Taipei City, Taiwan.
authors.forename: Wan-Ling
authors.initials: WL
authors.lastname: Ho
authors.affiliation: Department of Anatomic Pathology, Chang Gung Memorial Hospital and Chang Gung University, Linkuo, Taiwan.
authors.forename: Wen-Yu
authors.initials: WY
authors.lastname: Chuang
authors.affiliation: Department of Otolaryngology & Head and Neck Surgery, Chang Gung Memorial Hospital and Chang Gung University, Linkuo, Taiwan. Electronic address: kjchan5109@gmail.com.
authors.forename: Kai-Chieh
authors.initials: KC
authors.lastname: Chan
mesh_terms: D000208:Acute Disease; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D002277:Carcinoma / Q000000981:diagnostic imaging* / Q000473:pathology / Q000628:therapy; D059248:Chemoradiotherapy; D002945:Cisplatin / Q000008:administration & dosage; D003937:Diagnosis, Differential; D006801:Humans; D008113:Liver Neoplasms / Q000556:secondary; D008279:Magnetic Resonance Imaging; D008297:Male; D008417:Mastoiditis / Q000175:diagnosis*; D008875:Middle Aged; D000077274:Nasopharyngeal Carcinoma; D009303:Nasopharyngeal Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000628:therapy; D009364:Neoplasm Recurrence, Local / Q000000981:diagnostic imaging* / Q000473:pathology; D010031:Otitis / Q000175:diagnosis*; D050397:Radiotherapy, Intensity-Modulated; D014057:Tomography, X-Ray Computed
chemical_list: D002945:Cisplatin
keywords: Epstein–Barr-encoding region (EBER); In situ hybridization; Mastoid recurrence; Nasopharyngeal carcinoma (NPC); Otomastoiditis