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Two Sporadic Cases in a Western Population

Robert Louis Ferris, MD, PhD; Wayne Martin Koch, MD

Arch Otolaryngol Head Neck Surg. 2003;129:101-105.

Objectives  To increase awareness of the potential coexistence of connective tissue disease and nasopharyngeal carcinoma in a Western population, to consider possible causes for this phenomenon, and to provide recommendations for clinical management.

Design  Case report.

Setting  Academic tertiary referral practice.

Patients  Ninety-four patients with nasopharyngeal carcinoma were initially treated, and 20 were followed for 10 years. Of these, 2 were diagnosed as having coexistent connective tissue disease.

Main Outcome Measure  The clinical course of coexisting diseases.

Results  Most previous reports of the coexistence of nasopharyngeal carcinoma and connective tissue disease involve southern Chinese populations. There are distinct similarities between those series and the cases presented herein. The association can take several forms with differing order of presentation and spectrum of symptoms. A variety of mechanisms have been proposed for the dual development of the 2 disease states.

Conclusions  Connective tissue disease and nasopharyngeal carcinoma may coexist in white patients in a manner similar to that seen in Asian populations. Awareness of this possibility is an indication for special screening measures.

From the Department of Otolaryngology–Head and Neck Surgery, The Johns Hopkins University School of Medicine, Baltimore, Md. Dr Ferris is now with the University of Pittsburgh School of Medicine, Pittsburgh, Pa.

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