Nasopharyngeal Carcinoma: an Enigmatic Tumor.

Wei-Lin Tay, Puay-Hoon Tan, George Wai-Cheong Yip, Boon-Huat Bay


Nasopharyngeal cancer (NPC) is endemic in Southern China and South East Asia but is rare in the West. Men have a two to three times higher risk of developing the disease than women. NPC has been classified by the World Health Organization (WHO) into three categories based on the degree of differentiation, with WHO Type 3 being the most common histopathological type in endemic areas. The multifactorial etiologies of NPC include genetic predisposition, Epstein-Barr virus (EBV) infection, and environmental and dietary factors. Genetic linkage or association studies have demonstrated a correlation between the HLA haplotype and NPC susceptibility. Higher EBV antibody titers have been observed in most patients with undifferentiated NPC compared with normal controls. Consumption of salted fish containing volatile nitrosamines, especially during childhood, has been implicated as a possible factor contributing to NPC. The most common presenting symptom is enlarged cervical lymph nodes and patients may also have nasal, otological and neurological symptoms. Radiotherapy remains the main modality of treatment for this cancer.

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