Learning objectives
In view of the complexity of the head and neck region anatomy,
an accurate diagnosis and images interpretation of nasopharyngeal tumors remains a challenge.
The aim of our work was to:
Illustrate the magnetic imaging (MR) findings in nasopharyngeal carcinoma (NPC).
Understand the routes of extension of NPC.
Background
1/Anatomy
The nasopharynx is the superior portion of the tubular pharynx Fig. 1 ,its limits are:
·Superior: Central skull base.
·Inferior: The soft palate,
separating it from oropharynx.
·Posterior: The clivus and the two first cerical vertebrae.
·Anterior: Nasal cavity and choane.
·Lateral: The lateral walls of the nasopharynx are in continuity with the lateral oropharyngeal walls.
The pharyngobasilar fascia forms the wall of the nasopharynx.
Foramen of morgani is a small lateral attachment in pharyngobasilar fascia skull base,
through which the Eustachian tube pass...
Findings and procedure details
Detection of NPC:
In patients with high risk of NPC (elevated blood serology),
an endoscopic guided biopsy isperformed to sample the nasopharynx even when the endoscopy is normal.
MR is a valuable tool to detect small tumors that would aid in directing the site of biopsies and avoid to miss small mucosal lesions (6% of tumors not seen on endoscopy).
Staging of NPC:
It is important to understand the potential patterns of tumor spread in NPC to anticipate and detect subtle findings which may upstage...
Conclusion
MR imaging is a valuable tool to assess the routes of extension of NPC with providing multiplanar anatomic details .
An accurate assessment of the tumor extent is a challenge for the radiologist due to anatomic complexity of the region.
References
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Pitfalls in the staging of cancer of nasopharyngeal carcinoma.
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Cammoun M,
Attia RB,
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Nasopharyngeal carcinoma in children and adolescents in Tunisia: clinical aspects and the paraneoplastic syndrome.
IARC Sci Publ.
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al-Arayedh S,
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Nasopharynx: clinical,
pathologic,
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Nasopharyngeal carcinoma: the role of magnetic resonance imaging in diagnosis,
staging,
treatment,
and follow-up.
Top Magn...