Favorable Response to Intensity-Modulated Proton Therapy for Nasopharyngeal Non-Intestinal-Type Adenocarcinoma: A Case Report.
Naoya Sanda, Michi Sawabe, Yoriko Yamashita et al.
✦ AI-curated · Sources linked
Case in brief
A 56-year-old man presented with otitis media with effusion. Nasopharyngoscopy identified a mass on the left nasopharyngeal wall, and biopsy showed low-grade non-intestinal-type adenocarcinoma. Imaging found no invasion or metastasis; the tumor was staged cT1N0M0. Because surgery risked an insufficient deep margin, he received intensity-modulated proton therapy (64 GyRBE in 16 fractions). He developed acute treatment-related mucositis but completed therapy. Imaging showed complete remission, and he remained disease-free at 2 years of follow-up.
What made this case unusual
The case describes a favorable response to intensity-modulated proton therapy for this rare nasopharyngeal tumor, selected because of concern about achieving an adequate deep surgical margin.
Diagnostic / clinical pearl
Otitis media with effusion may prompt nasopharyngeal evaluation; in this case, nasopharyngoscopy and biopsy identified a low-grade tumor despite imaging showing no invasion or metastasis.
Why it matters
The reported remission supports further consideration of intensity-modulated proton therapy as a potential option when surgery may not achieve an adequate margin, although this single case cannot establish comparative effectiveness.