Recurrent nasopharyngeal carcinoma presenting as diffuse dermal lymphatic infiltration in the neck: Three case reports

Background. Any malignancy has the propensity to metastasize to skin. The f requency of skin metastases vary in different tumors and occur in about 0.7 % to 10%(1-3) of all patients diagnosed with cancer. It is rare in nasophar yngeal carcinoma. Method. Three cases of relapsed nasopharyngeal carcinoma with diffuse derma l involvement were described. Their clinical presentation. results of inves tigations, and response to treatment were reviewed. Literature review of si milar forms of presentation was done by means of a MEDLINE search. Results. At the time of dermal relapse, all three patients had a uniform cl inical picture of facial, periorbital, and lip swelling associated with str ider and dysphagia. Histologic findings showed dermal infiltrates of malign ant cells, and CT scan showed diffuse infiltration of the subcutaneous tiss ue. Despite chemotherapy, the clinical course was relentless. Conclusion. This report describes a presentation of disease that is underdi agnosed and heightens awareness of oncologists to this form of recurrence i n nasopharyngeal carcinoma. (C) 2001 John Wiley & Sons, Inc.