下位脳神経障害を契機に診断された上咽頭癌2例

概要

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Nasopharyngeal carcinoma has varied symptoms that often trigger its diagnosis, e.g., nasal symptoms, hearing loss, neck lymph node swelling, and diplopia, but rarely dysphagia or dysarthria caused by lower cranial nerve palsy. We report two cases of nasopharyngeal carcinoma. In case 1, a 74-year-old woman with dysphagia and dysarthria was found in magnetic resonance imaging (MRI) to have a bulky mass from the nasopharynx to the parapharyngeal space, tongue fasciculation, and left vocal cord palsy. Nasopharyngeal biopsy showed keratinizing carcinoma, which caused IX, X, and XII cranial nerve palsy. In case 2, a 77-year-old man with hoarseness and dysphagia was found in MRI to have a bulky mass similar to case 1, left vocal cord palsy, and left oropharyngeal paralysis. Biopsy showed undifferenciated carcinoma. Nasopharyngeal carcinoma caused IX and X cranial nerve palsy. Lower cranial nerve palsy should thus suggest the possibility of parapharyngeal space lesions.
耳鼻咽喉科臨床学会の論文
2010-11-01