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Radiological features of thyroid-like low-grade nasopharyngeal papillary adenocarcinoma: case series and systematic review

  • Head-Neck-ENT Radiology
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Abstract

Purpose

To comprehensively summarize the clinical data and CT/MRI characteristics of thyroid-like low-grade nasopharyngeal papillary adenocarcinoma (TL-LGNPPA).

Methods

Twenty-seven lesions from 25 study articles identified through a systematic review and three lesions from our institution associated with TL-LGNPPA were evaluated.

Results

The mean age of the patients at diagnosis was 35.7 years, and the male-to-female ratio was nearly half. The chief complaint was nasal obstruction, followed by epistaxis. All patients underwent excision. None of the patients had neck nodes or distant metastases. All patients survived with no locoregional/distant recurrence during 3–93 months of follow-up. All lesions were located at the posterior edge of the nasal septum, attached to the nasopharyngeal parietal wall, and showed no laterality. The mean lesion diameter was 1.7 cm. The margins of lesions were well-defined and lobulated, followed by well-defined smooth margins. None of lesions were associated with parapharyngeal space or skull base destruction. All lesions were iso- and low-density on non-contrast CT. Adjacent skull base sclerosis was detected in 63.6% of lesions. High signal intensity on T2-weighted imaging and mostly iso-signal intensity on T1-weighted imaging compared to muscle tissue. Most lesions were heterogeneous and exhibited moderate contrast enhancement. Relatively large lesions (≥1.4 cm) tended to be more lobulated than smooth margins compared to relatively small lesions (<1.4 cm) (p = 0.016).

Conclusion

We summarized the clinical and radiological features of TL-LGNPPA to facilitate accurate diagnosis and appropriate management.

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References

  1. Pineda-Daboin K, Neto A, Ochoa-Perez V, Luna MA (2006) Nasopharyngeal adenocarcinomas: a clinicopathologic study of 44 cases including immunohistochemical features of 18 papillary phenotypes. Ann Diagn Pathol 10:215–221. https://doi.org/10.1016/j.anndiagpath.2005.11.002

    Article  PubMed  Google Scholar 

  2. Oishi N, Kondo T, Nakazawa T et al (2014) Thyroid-like low-grade nasopharyngeal papillary adenocarcinoma: case report and literature review. Pathol - Res Pract 210:1142–1145. https://doi.org/10.1016/j.prp.2014.04.020

    Article  PubMed  Google Scholar 

  3. Lai Y, Li W, Zhai C et al (2021) Low-grade nasopharyngeal papillary adenocarcinoma: a review of 28 patients in a single institution. Cancer Manag Res 13:1271–1278. https://doi.org/10.2147/CMAR.S288007

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  4. Page MJ, McKenzie JE, Bossuyt PM et al (2021) The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ 372:n71. https://doi.org/10.1136/bmj.n71

    Article  PubMed  PubMed Central  Google Scholar 

  5. Murad MH, Sultan S, Haffar S, Bazerbachi F (2018) Methodological quality and synthesis of case series and case reports. BMJ Evidence-Based Med 23:60 LP. https://doi.org/10.1136/bmjebm-2017-110853

    Article  Google Scholar 

  6. Kurokawa R, Kurokawa M, Baba A et al (2021) Radiological features of head and neck mammary analogue secretory carcinoma: 11 new cases with a systematic review of 29 cases reported in 28 publications. Neuroradiology 63:1901–1911. https://doi.org/10.1007/s00234-021-02796-7

    Article  PubMed  Google Scholar 

  7. Baba A, Kurokawa R, Fukuda T et al (2022) Comprehensive radiological features of laryngeal sarcoidosis: cases series and systematic review. Neuroradiology 64:1239–1248. https://doi.org/10.1007/s00234-022-02922-z

    Article  PubMed  Google Scholar 

  8. Baba A, Kurokawa R, Fukuda T et al (2022) Radiological features of human papillomavirus-related multiphenotypic sinonasal carcinoma: systematic review and case series. Neuroradiology 64:2049–2058. https://doi.org/10.1007/s00234-022-03009-5

    Article  PubMed  Google Scholar 

  9. Baba A, Kurokawa R, Kurokawa M et al (2022) Imaging features of laryngeal chondrosarcomas: a case series and systematic review. J Neuroimaging 32:213–222. https://doi.org/10.1111/jon.12963

    Article  PubMed  Google Scholar 

  10. Baba A, Kurokawa R, Kurokawa M, Srinivasan A (2023) MRI features of sinonasal tract angiofibroma/juvenile nasopharyngeal angiofibroma: case series and systematic review. J Neuroimaging 33:675–687. https://doi.org/10.1111/jon.13116

    Article  PubMed  Google Scholar 

  11. Guo H, Zhang Z, Huang C et al (2023) Immunohistochemical characteristics of thyroid-like low-grade nasopharyngeal papillary adenocarcinoma: a case report and review. Medicine (Baltimore) 102:e32655

    Article  PubMed  Google Scholar 

  12. Chen F, Zhang Q, Tian X et al (2022) Efficacy of endoscopic resection and intensity-modulated radiotherapy for thyroid-like low-grade nasopharyngeal papillary adenocarcinoma: a case report. Transl Cancer Res 11:2408–2415

    Article  PubMed  PubMed Central  Google Scholar 

  13. Lee J-H, Kown J-H (2020) Nasopharyngeal papillary adenocarcinoma: a cotton Swab appearance on computer tomography. Ear, Nose Throat J 101:28–30. https://doi.org/10.1177/0145561320942684

    Article  Google Scholar 

  14. Karamitsou P, Poutoglidis A, Skliris JP et al (2022) An extremely rare nasopharyngeal malignant tumor: a case report. Cureus 14:e31444. https://doi.org/10.7759/cureus.31444

    Article  PubMed  PubMed Central  Google Scholar 

  15. Jibril YN, Salisu AD, Mustapha MI, Oluwafemi OOA (2022) A rare case of low-grade nasopharyngeal papillary adenocarcinoma in a young adult woman: a case report from a tertiary hospital in Northwestern Nigeria. J West Afr Coll Surg 12:107–110

    Article  PubMed  PubMed Central  Google Scholar 

  16. Yi L, Liu H (2021) Thyroid-like low-grade nasopharyngeal papillary adenocarcinoma with squamous differentiation in the posterior nasal septum: a rare case report. Medicine (Baltimore) 100:e28349

    Article  PubMed  Google Scholar 

  17. Compagnoni IM, Lamounier LA, Fontanini L et al (2021) Complete endoscopic resection of low-grade nasopharyngeal papillary adenocarcinoma: a case report. Braz J Otorhinolaryngol 87:237–240. https://doi.org/10.1016/j.bjorl.2020.10.004

    Article  PubMed  Google Scholar 

  18. Wang J, Luo S, Li Y, Zheng H (2021) Nasopharyngeal papillary adenocarcinoma harboring a fusion of ROS1 with GOPC: a case report. Medicine (Baltimore) 100:e24377

    Article  PubMed  Google Scholar 

  19. Theresia E, Dwianingsih EK, Rinonce HT et al (2020) Primary thyroid-like low-grade nasopharyngeal papillary adenocarcinoma in a 11-year-old male patient: the first case report in Indonesia. Hum Pathol Case Reports 21:200392. https://doi.org/10.1016/j.ehpc.2020.200392

    Article  Google Scholar 

  20. Maocai L, Fuxing L, Lianqing L et al (2020) Thyroid-like low-grade nasopharyngeal papillary adenocarcinoma: a case report. Medicine (Baltimore) 99:e21599

    Article  PubMed  Google Scholar 

  21. Wang J, Chen Z-Z, Lian C-L et al (2020) Thyroid-like low-grade nasopharyngeal papillary adenocarcinoma: a case report and literature review. Transl Cancer Res 9:4457–4463

    Article  PubMed  PubMed Central  Google Scholar 

  22. Lee SH, Kim H, Kim MJ et al (2020) Biphasic thyroid-like low-grade nasopharyngeal papillary adenocarcinoma with a prominent spindle cell component: a case report. Diagnostics 10:323

    Article  PubMed  PubMed Central  Google Scholar 

  23. Takakura H, Hamashima T, Tachino H et al (2020) Clinicopathological features of thyroid-like low-grade nasopharyngeal papillary adenocarcinoma: a case report and review of the literature. Front. Surg. 19:596796

    Article  Google Scholar 

  24. Baumann KB, Betz SJ (2019) Thyroid-like low-grade nasopharyngeal papillary adenocarcinoma. Head Neck Pathol 13:661–663. https://doi.org/10.1007/s12105-018-0947-x

    Article  PubMed  Google Scholar 

  25. Huang F, Xiang X, Hong B et al (2019) Thyroid-like low-grade nasopharyngeal papillary adenocarcinoma: a clinicopathologic study of five cases and a literature review. Am J Clin Pathol 152:582–589. https://doi.org/10.1093/ajcp/aqz082

    Article  PubMed  Google Scholar 

  26. Sourati A, Malekzadeh M, Rakhshan A (2019) Thyroid-like low-grade papillary adenocarcinoma of nasopharynx. BMJ Case Rep 12:e226949. https://doi.org/10.1136/bcr-2018-226949

    Article  PubMed  PubMed Central  Google Scholar 

  27. Yokoi H, Terado Y, Fujiwara M et al (2018) Biphasic low-grade nasopharyngeal papillary adenocarcinoma: a case report and literature review. BMC Clin Pathol 18:10. https://doi.org/10.1186/s12907-018-0076-1

    Article  PubMed  PubMed Central  Google Scholar 

  28. Ünsaler S, Başaran B, Aslan I, Yilmazbayhan D (2018) Endonasal endoscopic nasopharyngectomy for the treatment of nasopharyngeal papillary adenocarcinoma: report of a rare case. Int J Pediatr Otorhinolaryngol 104:51–53. https://doi.org/10.1016/j.ijporl.2017.10.041

    Article  PubMed  Google Scholar 

  29. Chen B-N, Wey S-L (2018) Thyroid-like low-grade nasopharyngeal papillary adenocarcinoma originating from the nasal septum. Int J Clin Exp Med 11:11326–11329

    Google Scholar 

  30. Oide T, Kadosono O, Matsushima J et al (2017) Thyroid-like low-grade nasopharyngeal papillary adenocarcinoma with squamous differentiation: a novel histological finding. Hum Pathol 70:43–48. https://doi.org/10.1016/j.humpath.2017.05.020

    Article  PubMed  Google Scholar 

  31. Yang S, Huang Y, Lu X et al (2017) Thyroid-like low-grade nasopharyngeal papillary carcinoma with a “biphasic” morphology: report of 3 cases and literature review. Int J Clin Exp Pathol 10:6038–6046

    Google Scholar 

  32. Horino T, Ichii O, Hamada-Ode K et al (2016) Thyroid-like low-grade nasopharyngeal papillary adenocarcinoma: a case report. Mol Clin Oncol 5:693–696. https://doi.org/10.3892/mco.2016.1056

    Article  PubMed  PubMed Central  Google Scholar 

  33. Borsetto D, Cazzador D, Prosenikliev V et al (2016) Nasopharyngeal thyroid-like low-grade papillary adenocarcinoma. B-ENT 12:235–240

    CAS  PubMed  Google Scholar 

  34. Ryu J, Park WS, Jung Y-S (2013) Exclusive endoscopic resection of nasopharyngeal papillary adenocarcinoma via combined transnasal and transoral approach. Clin Exp Otorhinolaryngol 6:48–51. https://doi.org/10.3342/ceo.2013.6.1.48

    Article  PubMed  Google Scholar 

  35. Ohe C, Sakaida N, Tadokoro C et al (2010) Thyroid-like low-grade nasopharyngeal papillary adenocarcinoma: report of two cases: case report. Pathol Int 60:107–111. https://doi.org/10.1111/j.1440-1827.2009.02480.x

    Article  PubMed  Google Scholar 

  36. Wenig BM, Hyams VJ, Heffner DK (1988) Nasopharyngeal papillary adenocarcinoma: a clinicopathologic study of a low-grade carcinoma. Am J Surg Pathol 12:946–953

    Article  CAS  PubMed  Google Scholar 

  37. Carrizo F, Luna MA (2005) Thyroid transcription factor–1 expression in thyroid-like nasopharyngeal papillary adenocarcinoma: report of 2 cases. Ann Diagn Pathol 9:189–192. https://doi.org/10.1016/j.anndiagpath.2005.04.019

    Article  PubMed  Google Scholar 

  38. Bai R, Sun J, Xu Y et al (2022) Incidence and mortality trends of nasopharynx cancer from 1990 to 2019 in China: an age-period-cohort analysis. BMC Public Health 22:1351. https://doi.org/10.1186/s12889-022-13688-7

    Article  PubMed  PubMed Central  Google Scholar 

  39. Kamran SC, Riaz N, Lee N (2015) Nasopharyngeal carcinoma. Surg Oncol Clin N Am 24:547–561. https://doi.org/10.1016/j.soc.2015.03.008

    Article  PubMed  Google Scholar 

  40. Ho FCH, Tham IWK, Earnest A et al (2012) Patterns of regional lymph node metastasis of nasopharyngeal carcinoma: a meta-analysis of clinical evidence. BMC Cancer 12:98. https://doi.org/10.1186/1471-2407-12-98

    Article  PubMed  PubMed Central  Google Scholar 

  41. Qu W, Li S, Zhang M, Qiao Q (2020) Pattern and prognosis of distant metastases in nasopharyngeal carcinoma: a large-population retrospective analysis. Cancer Med 9:6147–6158. https://doi.org/10.1002/cam4.3301

    Article  PubMed  PubMed Central  Google Scholar 

  42. Chen S, Yang D, Liao X et al (2022) Failure patterns of recurrence and metastasis after intensity-modulated radiotherapy in patients with nasopharyngeal carcinoma: results of a multicentric clinical study. Front. Oncol. 11:693199

    Article  PubMed  PubMed Central  Google Scholar 

  43. American Cancer Society Survival Rates for Nasopharyngeal Cancer. https://www.cancer.org/cancer/types/nasopharyngeal-cancer/detection-diagnosis-staging/survival-rates.html. Accessed 15 Sept 2023

  44. Razek AAKA, King A (2012) MRI and CT of nasopharyngeal carcinoma. Am J Roentgenol 198:11–18. https://doi.org/10.2214/AJR.11.6954

    Article  Google Scholar 

  45. King AD, Wong LYS, Law BKH et al (2018) MR imaging criteria for the detection of nasopharyngeal carcinoma: discrimination of early-stage primary tumors from benign hyperplasia. Am J Neuroradiol 39:515 LP–515523. https://doi.org/10.3174/ajnr.A5493

    Article  Google Scholar 

  46. Sireci F, Dispenza F, Lorusso F et al (2022) Tumours of nasal septum: a retrospective study of 32 patients. Int J Environ Res Public Health 19:1713

    Article  PubMed  PubMed Central  Google Scholar 

  47. Yang BT, Li SP, Wang YZ et al (2013) Routine and dynamic MR imaging study of lobular capillary hemangioma of the nasal cavity with comparison to inverting papilloma. Am J Neuroradiol 34:2202 LP–2202207. https://doi.org/10.3174/ajnr.A3523

    Article  Google Scholar 

  48. Lee DG, Lee SK, Chang HW et al (2010) CT features of lobular capillary hemangioma of the nasal cavity. Am J Neuroradiol 31:749 LP–749754. https://doi.org/10.3174/ajnr.A1908

    Article  Google Scholar 

  49. Motoori K, Takano H, Nakano K et al (2000) Pleomorphic adenoma of the nasal septum: MR features. Am J Neuroradiol 21:1948 LP–1941950

    Google Scholar 

  50. Baron S, Koka V, El Chater P et al (2014) Pleomorphic adenoma of the nasal septum. Eur Ann Otorhinolaryngol Head Neck Dis 131:139–141. https://doi.org/10.1016/j.anorl.2013.03.007

    Article  CAS  PubMed  Google Scholar 

  51. Kelly JH, Joseph M, Carroll E et al (1980) Inverted papilloma of the nasal septum. Arch Otolaryngol 106:767–771. https://doi.org/10.1001/archotol.1980.00790360045012

    Article  CAS  PubMed  Google Scholar 

  52. Park I-H, Lee HC, Lee H-M (2013) Respiratory epithelial adenomatoid hamartoma originating from nasal septum. Clin Exp Otorhinolaryngol 6:45–47. https://doi.org/10.3342/ceo.2013.6.1.45

    Article  PubMed  Google Scholar 

  53. Tong KN, Serra RM, Shih RY, Foss RD (2019) Seromucinous hamartoma of the nasal cavity. Head Neck Pathol 13:239–242. https://doi.org/10.1007/s12105-018-0914-6

    Article  PubMed  Google Scholar 

  54. King AD (2022) MR Imaging of nasopharyngeal carcinoma. Magn Reson Imaging Clin N Am 30:19–33. https://doi.org/10.1016/j.mric.2021.06.015

    Article  PubMed  Google Scholar 

  55. Siebert SM, Gomez AJ, Liang T et al (2018) Diagnostic performance of margin features in thyroid nodules in prediction of malignancy. Am J Roentgenol 210:860–865. https://doi.org/10.2214/AJR.17.18787

    Article  Google Scholar 

  56. Slone HW, Blake JJ, Shah R et al (2005) CT and MRI findings of intracranial lymphoma. Am J Roentgenol 184:1679–1685. https://doi.org/10.2214/ajr.184.5.01841679

    Article  Google Scholar 

  57. Horiuchi D, Shimono T, Tatekawa H et al (2022) Frequency and imaging features of the adjacent osseous changes of salivary gland carcinomas in the head and neck region. Neuroradiology 64:1869–1877. https://doi.org/10.1007/s00234-022-02972-3

    Article  PubMed  Google Scholar 

  58. Koyasu S, Sakurada H, Nakamoto Y (2023) Letter regarding the article “Frequency and imaging features of adjacent osseous changes of salivary gland carcinomas in the head and neck region” by Horiuchi and Shimono et al. Neuroradiology 65:1315. https://doi.org/10.1007/s00234-023-03199-6

    Article  PubMed  Google Scholar 

  59. Srinivasan A, Dvorak R, Perni K et al (2008) Differentiation of benign and malignant pathology in the head and neck using 3T apparent diffusion coefficient values: early experience. Am J Neuroradiol 29:40 LP – 44. https://doi.org/10.3174/ajnr.A0743

    Article  Google Scholar 

  60. Baba A, Kurokawa R, Kurokawa M et al (2022) ADC for differentiation between posttreatment changes and recurrence in head and neck cancer: a systematic review and meta-analysis. Am J Neuroradiol 43:442 LP – 447. https://doi.org/10.3174/ajnr.A7431

    Article  Google Scholar 

  61. Baba A, Kurokawa R, Rawie E et al (2022) Normalized parameters of dynamic contrast-enhanced perfusion MRI and DWI-ADC for differentiation between posttreatment changes and recurrence in head and neck cancer. Am J Neuroradiol 43:1184–1189. https://doi.org/10.3174/ajnr.A7567

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  62. Baba A, Kurokawa R, Kurokawa M et al (2023) Dynamic contrast-enhanced MRI parameters and normalized ADC values could aid differentiation of skull base osteomyelitis from nasopharyngeal cancer. Am J Neuroradiol 44:84–78

    Article  Google Scholar 

  63. Yan D-F, Zhang W-B, Ke S-B et al (2017) The prognostic value of pretreatment tumor apparent diffusion coefficient values in nasopharyngeal carcinoma. BMC Cancer 17:678. https://doi.org/10.1186/s12885-017-3658-x

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  64. Razek AAKA, Sadek AG, Kombar OR et al (2008) Role of apparent diffusion coefficient values in differentiation between malignant and benign solitary thyroid nodules. Am J Neuroradiol 29:563–568. https://doi.org/10.3174/ajnr.A0849

    Article  PubMed  PubMed Central  Google Scholar 

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Authors and Affiliations

  1. Department of Radiology, The Jikei University School of Medicine, 3-25-8 Nishi-Shimbashi, Minato-ku, Tokyo, 105-8461, Japan

    Akira Baba, Satoshi Matsushima, Hideomi Yamauchi, Nobuhiro Ogino, Reina Kayama, Kimiyuki Uchihara, Lynn Yoshimatsu & Hiroya Ojiri

  2. Department of Otorhinolaryngology, The Jikei University School of Medicine, 3-25-8 Nishi-Shimbashi, Minato-ku, Tokyo, 105-8461, Japan

    Hisashi Kessoku & Kazuhiro Omura

  3. Department of Radiology, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan

    Ryo Kurokawa

  4. Department of Pathology, The Jikei University School of Medicine, 3-25-8 Nishi-Shimbashi, Minato-ku, Tokyo, 105-8461, Japan

    Nei Fukasawa

  5. Department of Radiology, Kyorin University School of Medicine, 6-20-2, Shinkawa, Mitaka-shi, Tokyo, 181-8611, Japan

    Yuhei Takeshita

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  1. Akira Baba
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Correspondence to Akira Baba.

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Baba, A., Matsushima, S., Kessoku, H. et al. Radiological features of thyroid-like low-grade nasopharyngeal papillary adenocarcinoma: case series and systematic review. Neuroradiology 66, 249–259 (2024). https://doi.org/10.1007/s00234-023-03254-2

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