Nasopharyngeal carcinoma in young patients

Nasopharyngeal carcinoma (NPC) is rare in under 20-year-olds. Early diagnosis greatly improves survival. A retrospective review of 12 young NPC patients (seven males, five females, mean age 16 years) was performed to identify differing patient and tumour characteristics from adult NPC. Seventy-five per cent presented with neck lumps and 25% with headache. None had a family history of NPC or epistaxis. One patient had early stage NPC, and 11 had late stage NPC. Three late stage patients who received chemoradiotherapy had better clinical outcomes than six late stage patients receiving only radiotherapy. There were six deaths, five bony recurrences and one postnasal space recurrence. The 11 late stage patients' five-year actuarial survival was only 29%. Headache is an important symptom for young NPC. Late stage presentation and distant recurrences are also more common, supporting an increased role of chemotherapy.