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Staging at Presentation

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Presentation on theme: "Staging at Presentation"— Presentation transcript:

1 Staging at Presentation
Nasopharyngeal Carcinoma An 11 Year Study With Respect To Patient Characteristics, Clinical Aspects & Staging at Presentation Wani Shaqul Qamar, Talib Khan Sher I Kashmir Institute of Medical Sciences (SKIMS)

2 Poorly understood disease Racial & Geographical
Rare malignancy Confusing Poorly understood disease Racial & Geographical Orphanet J Rare Dis 2006;1:23. ICMR Bulletin 2003;33[9]. Cancer Epidemiol Biomarkers Prev 2006;15: Ann Acad Med Singapore 1990;19:201-7.

3 Anatomy Origin

4 Uncommon in the India Incidence < 1 per 100,000/Yr
Chin J Cancer 2011;30: Incidence < 1 per 100,000/Yr ICMR Bulletin 2003;33(9)

5 Kashmir Valley - Northern part India Distinct
Geography, Climate, Dietary Habits, Lifestyle Socio-culture Aspects

6 Aims & Objectives

7 Demographic Profile Lifestyle Aspects Clinical Presentation Histopathology Stage at Presentation

8 Material & Methods

9 Tertiary referral and University teaching hospital
The IEC approval Tertiary referral and University teaching hospital January December 2011 The case sheets – reviewed Demographic Profile, Lifestyle Aspects, Clinical Presentation,Histopathology, Stage at Presentation The standard statistical - Used

10 Observations

11 Age Age Years Minimum 12 Maximum 85 Median 49 Mean ± SD ± 16.43


13 Demographics

14 Diet & Life Style


16 Histopathology

17 Stage at Presentation

18 NPC Cases - Yearly

19 Case 1

20 20 Yr/F Ptosis R>L Loss of vision MRI brain Dec Normal


22 Started on steroids

23 MRI Brain May Normal

24 MRI Brain October 2011 Enhancement of L Optic Nerve & cavernous sinus


26 MRI Nov 2011 BL cavernous sinus & orbital apex syndrome with L optic neuritis

27 “Dilemma Continues”

28 Case 2

29 10 Yr/ male Submandibular swelling months Pain and fever Treated as Mumps and Symptomatically

30 FNAC metastatic deposits undiff CA
CECT H&N 4x5.2cm well defined modrately enhancing in NP (R side) ext nasal cavity, infra temp fossa, maxll sinus via orbital fissure into orbital apex, bone destruction, multiple cervical LN NP Bx/ IHC NPC / cytokeratin+

31 Conclusion

32 “Dietary and life Style plays a major role in the etiopatogenesis of NPC in Kashmir”

33 The GPs and Specialty physicians should R/O the possibility of NPC when patient with any of the symptoms of NPC are present

34 Thank you Pray for Kashmir

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