Eight years of clinical findings and biopsy results of nasopharyngeal pathologies in 1647 adult patients: a retrospective study.

OBJECTIVES: We performed an 8-year retrospective study to evaluate the presentation, clinical findings and nasopharyngeal biopsy results of adult nasopharyngeal pathologies.

METHODOLOGY: This study included 1647 patients (801 males and 846 females) admitted to outpatient clinics. All patients underwent a nasopharyngeal biopsy for a nasopharyngeal mass. In addition, a blind biopsy was taken if there was suspicion of nasopharyngeal carcinoma, even in the absence of a mass lesion. The pathological diagnoses were analysed on the basis of the age, sex and clinical presentation of the patients.

RESULTS: Patient age ranged between 18 and 85 years; the mean was 36 years. Patient age differed significantly between those with benign and malignant disease (p=0.000); the risk of malignancy increased with age. Benign disease was found in 97.4% of the patients. Reactive lymphoid hyperplasia was the most common condition; it was found in 92.71% of benign cases. Undifferentiated nasopharyngeal cancer was the most common malignant disease, being found in 82.95% of all nasopharyngeal malignancies and in 4.43% of all nasopharyngeal disease. The most common symptom was nasal obstruction. The other main symptoms were hearing loss and neck mass. Neck mass was associated with malignancy.

CONCLUSIONS: Benign disease of the nasopharynx is more common than malignant pathology in patients with a nasopharyngeal mass. Although adenoidal tissue undergoes regression in the adolescent period, this tissue may present as the chief cause of nasal obstruction in adults. Age and symptoms may predict malignant disease.