Nasopharyngeal cancer with neck recurrence at 8 years and a lung metastasis at 15 years after the first definitive radiotherapy: A case report

We report a patient with nasopharyngeal cancer with long-term follow-up of more than 16 years after the first course of radiotherapy in 1981. He devel oped a lung metastasis in 1996 after having a second course of radiotherapy for neck recurrence in 1989, The patient was a 42-year-old man with a naso pharyngeal tumor and a fixed upper neck metastasis (T1N1M0), which was trea ted with definitive radiotherapy. He manifested regional recurrence, at the margin of the radiation portal, with an 8 year disease-free interval, whic h was treated successfully by definitive re-irradiation. He developed a sol itary lung metastass, which was treated by video-assisted thoracoscopic lun g resection, 7 years disease-free after the second course of radiotherapy. For 20 months after the removal of the lung metastasis he has been generall y well without any signs of recurrence or sequelae. This case indicates the efficacy of definitive re-irradiation for regional recurrence and the nece ssity for long-term observation after radiation therapy for nasopharyngeal cancer.