Recidiva de linfoma del manto en nasofaringePresentación de un caso

Abstract

Introduction and objective: Nasopharyngeal tumors are rare and often difficult to diagnose due to limited access to this region. Up to 60% of non-Hodgkin's lymphomas develop in extranodal areas; Of these, more than half are located at the head and neck area;  Waldeyer's ring are one of the most frequent locations. Mantle lymphoma has intermediate aggressiveness and reduced survival and is more common in older people. Method: We present the case of a 90-year-old man with a history of mantle lymphoma treated in 2018 who attended the Emergency Department due to nasal obstruction symptoms. Results: A 90-year-old man with a history of mantle lymphoma who was treated in 2018. He consulted to the Emergency Department due to symptoms of bilateral nasal obstruction of approximately 3 months of evolution, which has progressively increased, with mouth breathing throughout the day and night snoring. Treated by her primary care physician as rhinitis without improvement despite several treatments. The examination shows complete occupation of the nasopharynx due to a smooth-surface tumor that enters through both choanae towards the nostrils, as well as protrusion of the left soft hemipalate; no palpable cervical lymphadenopathy. The contrast-enhanced CT scan showed practically complete occupation of the nasopharynx by a large mass of 72x47x60 mm, which contacts the deep lobe of the left parotid gland and the internal wall of the ipsilateral mandibular ramus, and protrudes towards the palate; it contacts cranially with the clivus and some point of infiltration of the internal carotid cannot be ruled out. A biopsy was performed under local anesthesia with the result of mantle lymphoma. The patient is referred to a Hematology consultation to assess treatment. Conclusions: The diagnosis of any tumor of the nasopharynx is often carried out late, since they do not usually give symptoms until they reach advanced stages. In older people, lymphomas are one of the most frequent histological types. Since non-Hodgkin's lymphomas are very frequently located in extranodal regions such as Waldeyer's ring, and mantle lymphoma, in particular, has a disease-free time of approximately one year with conventional treatments, the appearance of ENT symptoms in patients with a history of this type of lymphoma should alert us to a possible recurrence in our area