Histologically diagnosed cases of nasopharyngeal carcinoma in two Nigerian children within one year period: case reports and review of literature

Abstract

Background: Nasopharyngeal carcinoma is a rare tumour arising from epithelium of the nasopharynx. It constitutes only 1-5% of all cancers. In Nigeria, it represents 1.7-2% of all cancers with a prevalence rate of 4/100,000. The incidence of nasopharyngeal carcinoma in children is even rarer, accounting for less than 1% of all childhood malignancies. Ten to twenty percent of nasopharyngeal carcinoma in Nigeria occurs in children.

Aim: To increase the index of suspicion of clinicians to this disease in children for prompt diagnosis and management.

Case Reports: The patients were 8 and 16 year-old Nigerian males who presented with painless neck swelling at the paediatric clinic of a tertiary hospital in south eastern Nigeria. Both were misdiagnosed and managed for tuberculous lymphadenitis until a histological diagnosis suggested nasopharyngeal carcinoma. They were referred to a paediatric oncologist at a premier tertiary hospital for further management, following confirmation by otorhinolaryngologists.

Conclusion: Though rare, nasopharyngeal carcinoma should be included as a differential in children presenting with cervical lymphadenopathy. As a result, a throat examination by an ENT surgeon should be made routine in all children presenting with cervical lymphadenopathy. This is desirable since early diagnosis and prompt treatment lead to a better prognosis.

Keywords: Airway, cervical, children, lymphadenopathy, tuberculosis