NASOPHARYNGEAL CARCINOMA IN A VERY YOUNG-CHILD - EFFICACY OF CHEMORADIATION AND LATE MORBIDITY

Purpose. Nasopharyngeal carcinoma occurs predominantly in the adult po pulation in southern China and Southeast Asia. It is a very rare disea se in North America, especially in children younger than 10 years of a ge. We describe a 6-year-old boy with nasopharyngeal carcinoma seen wi th a cervical mass, who later developed growth hormone deficiency afte r chemoradiation therapy. Patient and Methods. The child was treated w ith neoaduvant chemotherapy followed by delayed radiation of 6300 cGy to the primary site of the tumor and further maintenance chemotherapy for a full year. Two years after therapy, concerns regarding the child 's short stature resulted in an endocrine evaluation that included ass essments of growth and pubertal stage, thyroid function, and adrenal f unction. Results. Six years after therapy, the patient is free of tumo r but survives with hypothalamic-pituitary axis dysfunction requiring growth hormone supplement. Conclusions. The recommendation is made to include nasopharyngeal carcinoma in the differential diagnosis of a ce rvical mass in a young child. The occurrence of long-term endocrine mo rbidity in children receiving high-dose radiation to the hypothalamic- pituitary area is emphasized, and recommendations are also made regard ing endocrine evaluation posttherapy.