Case 71

Nasopharyngeal carcinoma of the Regaud type

Published on 16.01.2000

DOI:

10.1594/EURORAD/CASE.71

ISSN:

1563-4086

Section:

Head & neck imaging

Technique:

MR

Technique:

MR
Case Type: Clinical Cases

Authors:

Lemort M, Leurquin M

Patient:

32 years, male

Clinical History:

Large tumour of the nasopharynx found after complaints of persistant facial pain

Imaging Findings:

This patient, a woodworker, was referred in our institution for staging of a large rhinopharyngeal tumour discovered after persistent pain following extraction of a right superior molar tooth. A trigeminal neuralgy was already diagnosed. A MR examination is performed using following sequences : T1w SE axial and frontal pre and post Gd DOTA, T2w SE axial. Where is the posterior limit of the lesion ? What about the masticator space ? Is there any intracranial extension ? How do you explain the high signal on the T2w images of the mastoid cells ?

Discussion:

Both the retropharyngeal spaces and the left prevertebral space are involved. The tumour infiltrates the masticator space with a perineural extension around the V3 nerve up to Meckel's cave. The intracranial extension follows a perineural way (V3 --> foramen ovale --> Meckel's cave) and a contiguous way through the sphenoid sinus. The hypersignal in the mastoid cells is caused by middle-ear fluid resulting from Eustachian tube malfunction (probably due to a tumour infiltration of the torus tubarii). Diagnosis was confirmed by biopsy : nasopharyngeal epithelioma (Regaud type). This refers to an undifferenciated nasopharyngeal carcinoma with foci of cells from epithelial origin (ref.1-3). The patient was only partially treated by chemo- and radiotherapy because he was lost of follow-up.

Differential Diagnosis List:

Undifferenciated nasopharyngeal carcinoma (Regaud type)

Final Diagnosis:

Undifferenciated nasopharyngeal carcinoma (Regaud type)

References:

James JM, Weill B, Bernadou A, Temim L, Tricot G, Diebold J, Zittoun R, Bilski-Pasquier G (1976)
Undifferentiated naso-pharyngeal carcinoma of the Schmincke-Regaud type. Apropos of 3 cases
Ann Med Interne 127(6-7):421-8.
Saussez S, Heimann P, Vandevelde L, Bisschop P, Jortay A, Schandene L, Cogan E (1997)
Undifferentiated carcinoma of the nasopharynx and leukemoid reaction: report of case with literature review.
J Laryngol Otol 111(1):66-9.
Resa L, Ricco R, Santangelo A (1983)
Morphologic and classificatory considerations about 140 cases of carcinoma of the nasopharynx.
Tumori 69(4):313-21.

Figure 1

Figure 2