Table 2 Demographics, clinical features, treatment and outcomes of nasopharyngeal lymphoma patients with presentation of cranial nerve palsy OR pituitary dysfunction
Author,[Reference] | Age (years),gender | Clinical presentation | Other clinical features | Neurological deficits | Radiological findings | Histological diagnosis | Treatment and outcome |
|---|---|---|---|---|---|---|---|
Mohammadianpanah, [28] | 1 patient (Not described) | A bulky primary tumor and regional cervical lymphadenopathy was defined as a size ≥5 cm in its maximal diameter | Nasal obstruction and dysphagia | 3th and 6th cranial nerve palsy | Extension to the adjacent structures; most commonly into the nasal cavity | Non-Hodgkin’s lymphoma of the nasopharynx | CHOP regimen and radiation therapy |
Lopes da Silva, [29] | 28,Male | Diplopia | Proptosis of the eye | Involvement of the trigeminus nerve | Infiltration of the posterior-inferior side of the right orbit | B lymphoblastic lymphoma of the nasopharynx | Complete remission of the disease after 2 years. |
KAY, [30] | 19, Male | Ulceration of the soft palate and uvula | Blepharoptosis of the left eye, weakness of the right side of face, diplopia, and a funny taste. | 6th nerve paralysis. A right peripheral 7th nerve palsy. Motor pupil defect on the right. 4th nerve palsy, partial 3th nerve palsy on the right | Chest x-ray shows hilar enlargement, nodular densities and cavitary lesions | Diffuse infiltrate of atypical lymphocyte in nasopharyngeal biopsy | Radiation therapy to the base of the brain. Dexamethasone and cyclophosphamide orally. Died shortly |
Keane, [31] | 3 patients (Not described) | Presence of severe weakness, atrophy or fasciculations, and deviation of the tongue on protrusion. | Â | Twelfth-Nerve Palsy and 3th,5th, 6th10th, 11th may to impair | MR imaging evidence of a large nasopharyngeal mass spreads within the cavernous sinus and extend laterally into the neck | Nasopharyngeal lymphoma | Radiation |
RIGGS, [32] | 50, Male | Double vision, vertigo, and unsteady gait | External rectus muscle paralysis | Right 6th nerve palsy | Infiltration of the left cavernous sinus and dura over the Gasserian ganglion with malignant | Nasopharyngeal lymphoma | Died in 6 month |
RIGGS, [32] | 30, Male | Painless, rapidly growing mass on the left side of the neck, suddenly became blind in the left eye and developed | Ptosis on the left eye. Numbness of the left side of the face, dilated and fixed pupil on the left with limitation of all movement of the eyeball. | Left peripheral facial palsy with weakness of the right side of the face | Both cavernous sinuses and the left carotid artery was obliterated by the mass. Metastatic tumor was present in the lung and pancreas and cervical lymph nodes. | Nasopharyngeal lymphoma | X-ray therapy, died in 6 month |
RIGGS, [32] | 50, Male | Painful mass on the right side of the neck, pain and ptosis of the left lid |  | 6th nerve palsy | The Gasserian ganglia were embedded in tumor, and neoplastic tissue obliterated the subdural space of both optics nerves. | Nasopharyngeal lymphoma | Died 31 month later |
RIGGS, [32] | 36, Male | Painless growth on the left side of the neck |  | Left peripheral facial palsy and 3,4,6,9,10 nerve palsy | A mass filled dorsum of the sella, petrous bone, and the adjacent sphenoid bone. Obliterated the cavernous sinus on this side and constricted the internal carotid | Nasopharyngeal lymphoma | 2 years |
RIGGS, [32] | 34, Male | Pain and fullness in the throat for three months. Severe, constant pain in the right side of the face. | Weakness of the soft palate, and decreased hearing on the right. Weakness of the right sternocleidomastoid muscle. | Partial peripheral facial palsy | Destruction of the right middle fossa | Nasopharyngeal lymphoma | Died after 29 month |
Van der Vliet [33] | 47, Female | Pain in right middle ear and right-sided hearing loss and tinnitus. Loss of sensation of the right half of the tongue | The pupil of the left eye was larger than that of the right | Unilateral multiple cranial nerve dysfunction. (nerves V, VII, VIII, IX, X, and XII) | Effusion of the mastoid air cells and middle ear. Intracranial extension via the foramen ovale into Meckel’s cavity and in the hypoglossal canal | Nasopharyngeal B-cell non-Hodgkin’s lymphoma | CHOP chemotherapy, died early |
Ingram [34] | 5patients (male aged 4,10,4,15;female aged 9) | (Not described specifically) | (Not described specifically) | 3th and 7th cranial nerve palsy | (Not described specifically) | Nasopharyngeal B-cell non-Hodgkin’s lymphoma | Radiation,3of them alive,2 of them died |
Bunick [35] | 47,Male | Diplopia, headache, Lethargy, hearing loss | Pan hypopituitarism, Low libido, coldness, loss of body hair | – | Skull X-ray -destruction of floor of sella | Nasopharyngeal Hodgkin’s lymphoma | MOPP Rdx, T4, T, GC as hormone treatment |
Current case | 64, Female | Intermittent diplopia. Severe headache, left eye ptosis, and hypoglycemic episodes | Pan hypopituitarism generalized weakness, generalized musculoskeletal pain, and 6–7 kg weight loss | Left eye 3rd, 4th, and 6th nerve palsy. But, she was not anisocoric and the pupillary reflexes were normal on both eyes | MRI showed a heterogeneous enhancement in the seller and suprasellar regions, enlargement of the stalk, parasellar dural enhancement and thickening of the sphenoid sinus without any bone erosion | low-grade non-Hodgkin’s B-cell lymphoma | CHOP chemotherapy. Oral prednisolone and levothyroxine. Central adrenal insufficiency,partial CDI and central hypothyroidism have been resolved. |