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Pediatric Nasopharyngeal Carcinoma as Seen on 18F-FDG PET/CT

Razi Muzaffar1, Francesca Vacca2, Huazhang Guo2

  • 1Division of Nuclear Medicine, Department of Radiology, Saint Louis University, Saint Louis, MO, United States.

Frontiers in Oncology
|March 22, 2019
PubMed

Insights

Pediatric nasopharyngeal carcinoma, a rare cancer linked to Epstein-Barr virus, often presents with delayed diagnosis due to non-specific symptoms. This case highlights migraines as an unusual initial symptom in a teenager.

Area of Science:

  • Oncology
  • Virology
  • Otolaryngology

Background:

  • Pediatric nasopharyngeal carcinoma (NPC) is a rare malignancy.
  • Epstein-Barr virus (EBV) infection is strongly associated with NPC.
  • Delayed diagnosis is common due to non-specific presenting symptoms.

Observation:

  • A previously healthy 17-year-old female presented with intractable migraines.
  • Initial symptoms were misdiagnosed as dental infection, with antibiotics providing no relief.
  • An otolaryngologist identified a large mass in the left nasal cavity.

Findings:

  • Imaging confirmed a large mass in the posterior left nasal cavity.
  • Biopsy results were consistent with nasopharyngeal carcinoma.
  • This case underscores the importance of considering rare diagnoses for persistent, unexplained symptoms.

Implications:

  • Highlights the need for a broad differential diagnosis in pediatric patients with persistent, unusual symptoms.
  • Emphasizes the potential for delayed diagnosis of nasopharyngeal carcinoma.
  • Suggests that atypical presentations like chronic migraines warrant thorough investigation in pediatric oncology.

Keywords:
Epstein-Barr virusFDGPET/CTnasopharyngeal carcinomapediatrics

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