2019年6月29日星期六

Tumours of the nasopharynx (鼻咽部腫瘤)

Angiofibroma (鼻咽血管纖維瘤)

Incidence:
A benign vascular tumour occurring in males under the age of 25 years.

Clinical features:
Nasal obstruction, epistaxis and deafness due to middle ear effusion are common characteristics.

Management:
Treatment is by surgical excision, facilitated by preoperative CT scanning, arteriography and embolization.


Malignant tumours (惡性腫瘤)

Incidence:
Common in south east Asia, where they account for 20% of all malignant tumours.

Clinical features:
Present as nasal obstruction, epistaxis and deafness. Metastasis to cervical nodes may occur prior to local symptoms becoming apparent. Cranial nerve palsies occur in advanced cases.

Pathology:
Most are squamous carcinomas, although anaplastic carcinomas and lymphomas also occur.

Management:
Radiotherapy following biopsy confirmation, with surgery used only for cervical nodes not responding to irradiation.


Chordoma (脊索瘤)

A very rare locally invasive neoplasm arising from remnants of the fetal notochord found in the skull base. Presents with neurological, nasal and ophthalmic symptoms.


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