Paediatric Nasopharyngeal Carcinoma a Rare Entity; Experience from a Tertiary Care Children Hospital

Abstract

Background: In the paediatric population, Nasopharyngeal carcinoma (NPC) is a rare tumour of head and neck region arising from epithelial cells of nasopharynx. There is racial, geographical and age wise variability in the incidence of NPC. Most of the cases occur in south east Asia, southern China and Africa while in the rest of the world incidence of NPC is relatively low. Objective: To determine clinical features, stage of disease at presentation, treatment and outcome in children presenting with nasopharyngeal carcinoma to our hospital. Methods: Analytical cross sectional study was conducted in The Department of Paediatric Haematology/Oncology, The Children's Hospital and the Institute of Child Health, Lahore. Children less than 18 years who presented to the hospital from Jan 2016 to Dec 2020 with nasopharyngeal carcinoma (NPC) were included in the study. Complete medical record of the patients was reviewed and data including demographic detail, symptoms, treatment and outcome was collected and analysed with SPSS v 19.0. Results: Thirty children diagnosed with NPC were included in the study. Their mean age was 11.83±1.86 years and male to female ratio was 2.75:1. Majority of children belonged to rural areas. 12(40%) patients had stage III and 18(60%) patients had stage IV disease. Most common symptom at presentation was neck swelling 21(70%) followed by headache 5(16.7%), neurological 2(6.7%), ear 2(6.7%) and nasal symptoms 1(3.3%). 14(46.7%) patients got complete remission and are well, 1(3.3%) patient had residual disease, 13(43.33%) patients died and 2 (6.7%) patients lost follow up. Cumulative overall survival was 44% while cumulative event free survival was 40%. Conclusion: Nasopharyngeal carcinoma is a rare tumour of head and neck. It is most prevalent in male children. Major symptom at presentation is neck swelling. Children usually present at advanced stage of disease due to which mortality is high.