Case report

Refractory lympho-epithelial carcinoma of the nasopharynx: a case report illustrating a protracted clinical course

Frederick Y Wu^1,2* , Eddy S Yang^1* , Christopher D Willey¹ , Kim Ely³ , Gaelyn Garrett⁴ and Anthony J Cmelak¹

¹  Department of Radiation Oncology, Vanderbilt University School of Medicine, Nashville, TN, USA

²  Department of Radiation Oncology, University of California at San Francisco, San Francisco, CA, USA

³  Department of Pathology, Vanderbilt University School of Medicine, Nashville, TN, USA

⁴  Department of Otolaryngology, Voice Center, Vanderbilt University School of Medicine, Nashville, TN, USA

author email corresponding author email* Contributed equally

Head & Neck Oncology 2009, 1:18doi:10.1186/1758-3284-1-18

Published:	15 June 2009

Abstract

Nasopharyngeal carcinoma is an uncommon cancer in North America. Its clinical course is typified by locally advanced disease at diagnosis and has a high propensity for both regional and distant spread. It is, therefore, typically treated with a combination of radiation and chemotherapy. This report describes our 10-year clinical and radiological findings in a 48-year-old Vietnamese male patient with locally-advanced T4N1M0 lympho-epithelial carcinoma of the nasopharynx. Despite a long remission period after his initial course of aggressive chemoradiation, his tumor recurred locally after 4 years. Thereafter, throughout a period of over 10 years, he has been treated with multiple courses of re-irradiation and three different trials of chemotherapy. He was ultimately provided with over 30 months of progression-free tumor control with the epidermal growth factor receptor (EGFR)-inhibitor cetuximab. This case illustrates the commonly protracted course of this disease and its responsiveness to multiple treatment modalities.