Cases reported "Nasopharyngeal Neoplasms"

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1/11. Hypertrophic osteoarthropathy in a child with nasopharyngeal carcinoma.

    We report a 13-year-old boy with nasopharyngeal carcinoma, skull metastases and hypertrophic osteoarthropathy. Although the metastases and the primary tumour responded well to chemotherapy, hypertrophic osteoarthropathy persisted during follow-up.
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2/11. Hypertrophic osteoarthropathy: an unusual manifestation in nasopharyngeal cancer.

    A patient with nasopharyngeal carcinoma developed clubbing and hypertrophic osteoarthropathy 6 months before radiological detection of secondary deposits in the lung. Another patient with nasopharyngeal carcinoma developed digital clubbing and hypertrophic osteoarthropathy 6 months after the discovery of lung metastases. Development of a paraneoplastic syndrome in the form of hypertrophic osteoarthropathy and digital clubbing is very rare. This manifestation of nasopharyngeal cancers is presented, with a short review of its biology and pathogenesis.
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3/11. A case of hypertrophic osteoarthropathy associated with nasopharyngeal carcinoma in a child.

    Hypertrophic osteoarthropathy is characterized by clubbing of the digital tips and periosteal reaction of long bones. Most of the cases are associated with malignancy or other conditions such as congenital heart disease, liver cirrhosis, pulmonary fibrosis, biliary atresia, and gastrointestinal polyps. Hypertrophic osteoarthropathy associated with malignancy is rare in children. A few cases of hypertrophic osteoarthropathy in children with nasopharyngeal carcinoma have been reported, however, there has been no report of such case in korea. We present a case of hypertrophic osteoarthropathy associated with nasopharyngeal carcinoma with lung metastasis in a 14-yr-old boy. In this case, hypertrophic osteoarthropathy regressed after intensive chemotherapy, but subsequently the patient died of progressive lung metastasis.
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4/11. Hypertrophic non-pulmonary osteoarthropathy in a patient with nasopharyngeal carcinoma.

    A 20-year-old woman with nasopharyngeal carcinoma, in clinical remission, developed pains in the wrists and knees. Radiological and scintigraphic evaluation revealed tumor recurrence and bone metastases. No pulmonary involvement was observed. Reinstitution of combined chemotherapy resulted in abolition of the metastatic lesions and resolution of her rheumatic complaints.
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5/11. Hypertrophic osteoarthropathy, cutaneous vasculitis, and mixed-type cryoglobulinemia in a patient with nasopharyngeal carcinoma.

    We describe a 27-year-old woman with a primary nasopharyngeal carcinoma who developed hypertrophic osteoarthropathy and cutaneous vasculitis. Her serum contained antibodies to Epstein-Barr virus and U1 RNP antigens. Cryoproteins isolated from her serum contained antibodies to U1 RNP and a protein with a molecular weight of 32 kd which reacted specifically with antibodies to U1 RNP. HLA typing revealed HLA-B7 and DR1; these have been reported to be increased in Japanese patients with rheumatic diseases who have autoantibodies to U1 RNP. These findings indicate that some features of the paraneoplastic syndrome in this patient might have been caused by immune complexes, part of which were formed by specific autoantibodies produced under genetically controlled conditions of immune responsiveness.
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keywords = osteoarthropathy
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6/11. Nasopharyngeal carcinoma complicated by pseudohypertrophic osteoarthropathy.

    This paper describes a case of nasopharyngeal carcinoma complicated by pseudohypertrophic osteoarthropathy due to pulmonary metastasis following radiotherapy. A similar clinical picture may be seen in pseudohypertrophic osteoarthropathy, rheumatoid arthritis and carcinomatous arthritis. It is important clinically to differentiate them from one another. One should search carefully for an intrathoracic secondary lesion when pseudohypertrophic osteoarthropathy occurs in a case of nasopharyngeal carcinoma following radiotherapy.
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7/11. Hypertrophic osteoarthropathy in childhood malignancy.

    A case of hypertrophic osteoarthropathy associated with carcinoma of the nasopharynx in a child is presented. Peculiar findings were the minor changes on the chest film, and the absence of periosteal reactions in the radii.
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8/11. Hypertrophic pulmonary osteoarthropathy heralding relapse of lymphoepithelioma.

    Hypertrophic pulmonary osteoarthropathy is an uncommon paraneoplastic syndrome occasionally associated with nasopharyngeal lymphoepitheliomas. We treated two patients with previously diagnosed lymphoepitheliomas in whom hypertrophic pulmonary osteoarthropathy preceded the recognition of pulmonary metastases. Both patients' disabling arthritic syndromes resolved with effective therapy directed at their neoplasms.
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9/11. Hypertrophic osteoarthropathy in childhood malignancy.

    Hypertrophic osteoarthropathy (HOA), well known in adults, is rarely encountered in children. The clinical features include clubbing of the fingers and toes, arthritis, and a sometimes painful ossifying periostitis of the tubular bones. Apart from a hereditary form (primary HOA), most of the cases encountered in children are secondary and associated with conditions such as chronic suppurative lung processes (e.g., cystic fibrosis), congenital heart disease, biliary atresia, and polyposis coli. The association with malignant disorders, which is relatively common in adults, is very rare in children. In 1986 the authors published a case report of a patient with carcinoma of the nasopharynx who developed HOA. Another similar patient has been encountered. In both, the appearance of HOA was associated with a very poor prognosis. A meticulous research of the literature from 1890 to 1990 revealed only 24 children (19 boys, 5 girls) under the age of 18, with malignancy and associated HOA. Among them were 10 patients with a carcinoma of the nasopharynx, 8 with osteosarcoma, 3 with Hodgkin's lymphoma, 1 with a periosteal sarcoma, 1 with mesothelioma of the pleura, and 1 with carcinoma of the thymus. In five patients with HOA, there were no abnormalities of the lungs, mediastinum, or pleura, and none developed during the course of the disease. Many authors mention the predictive value of HOA, especially in association with malignant tumors. In contrast to suppurative processes in the lungs, in those with neoplastic disease involving the chest, HOA may precede pulmonary symptoms by 1-18 months. A striking feature of HOA in these instances is the reversibility of the complaints after successful treatment of the disorder of the chest, both in benign and malignant conditions. The present case is the second reported by the authors and the first description of a girl with carcinoma of the nasopharynx developing HOA.
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keywords = osteoarthropathy
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10/11. radiotherapy for extreme hypertrophic pulmonary osteoarthropathy associated with malignancy.

    A patient with florid hypertrophic pulmonary osteoarthropathy (HPOA) associated with metastatic nasopharyngeal carcinoma is presented. Despite the presence of metastatic disease in the thorax and in bone, the patient's main symptom was severe pain from the HPOA, which was temporarily relieved by chemotherapy. Her disease subsequently progressed during chemotherapy and the pain became resistant to conventional treatment, including high dose morphine, non-steriodal anti-inflammatory agents and steriods. It was only with local radiation to the involved joints that the pain could be controlled. Our patient demonstrates that local radiotherapy is an option for the palliation of extreme HPOA.
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keywords = osteoarthropathy
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