Title: The CT manifestations of nasopharyngeal carcinoma in a series of 1100 cases
Abstract: Objective:The purpose of this study was to recognize tumor spreading patterns of nasopharyngeal carcinoma(NPC)at the primary sites on the initial CT scans.Methods:CT scans of 1100 patients with histologically proven NPC,who were treated in our hospital from 1991 to 2006 with intact clinical and imaging files,were retrospectively reviewed by two experienced radiologists.Those patients included 807 men and 293,women with ages ranging from 11 to 85 years(median 48 years).The location and extension of the primary tumors on the initial CT scans were analysed,especially whether or not and in which way the tumors involved in the skull base or grew into any of the adjacent neck spaces.All the data were statistically processed with SPSS 11.5 software.Results:The tumor spreading patterns of the 1100 cases were classified into 3 types.336 cases(30.54%)were type 1,superficial growing type,which meant that tumor was confined to the nasopharyngeal cavities.317 cases(28.82%)were type 2,adjacent invasion type,which was defined as that the tumors only invaded the adjacent spaces.447 cases(40.64%)belonged to type 3,ultra-cavity invasive type,which indicated that tumor grew beyond the adjacent spaces.The skull base was involved in 445 cases(40.45%).The leading site involved was sphenoid sinus in 330 cases(30%),followed by foramen lacerum in 293(26.64%),the pterygoid process in 276(25.09%),the pterygoid canal in 268(24.36%),clivus in 226(20.55%),the pterygopalatine fossa in 205(18.64%),foramen ovale in 201(18.27%),foramen spinosum in 195(17.73%),the cavernous sinus in 154(14%),the infraorbital fissure in 147(13.36%),and the petrooccipittal fissure in 137(12.45%).A total of 228 sides of the pterygopalatine fossa in 205 cases were involved.And among them,161 sides(70.61%)in 143 cases were via the sphenopalatine foramen.From the pterygopalatine fossa,tumors grew further into the infraorbital fissure on 144 sides(63.16%).And from the infraorbital fissure,tumors invaded the supraorbital fissure on 28 sides(12.28%),the cavernous sinus on 27 sides(11.84%),the round foramen on 91 sides(39.91%),and the orbital apex on 44 sides(19.30%)respective-ly.Conclusion:The common sites to be invaded by the primary tumors of nasopharyngeal carcinoma in descending order were the sphenoid sinus,the foramen lacerum,the pterygoid process,the pterygoid canal,clivus,the pterygopalatine fossa,foramen ovale,foramen spinosum,cavernous sinus,infraorbital fissure and others.When the pterygopalatine fossa was involved,special attention should be paid to the possible further extensions into the adjacent structures through the connected canals,such as to the orbital apex,the supraorbital fissures or the cavernous sinus via the infraorbital fissures.
Publication Year: 2008
Publication Date: 2008-01-01
Language: en
Type: article
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