Carcinoma of the nasopharynx in children

Seven children with carcinoma of the nasopharynx have been treated and followed for five years. In this group of patients there were no cranial nerve palsies or radiographic evidence of destruction of the base of the skull. Four of the seven patients are living and well. The development of lymphoepithelioma in two siblings is of great interest from an environmental and genetic point of view. The older sibling developed the clinical manifestations of the tumor at 12 years of age and four years later the younger sibling developed them at 14 years of age. The possible etiologic relationship of carcinoma of the nasopharynx to the Epstein-Barr virus is discussed. The good survival rate in these patients under 21 years of age suggests that the prognosis in carcinoma of the nasopharynx is better in the younger age group than in adults. The management of these patients illustrates that carcinoma of the nasopharynx should be managed as a regional rather than a systemic disease. Systemic drug therapy is sometimes advocated because of confusion over the name lymphoepithelioma on the assumption that these tumors are more related to lymphomas and lymphosarcomas than carcinomas. It is clear that lymphoepitheliomas should be managed as carcinomas.