Resection of radiation-induced sarcoma in the nasopharynx using transpalatal approach with mandibular swing combined with nasal endoscopy

Abstract

Surgical resection is one of the salvage treatment options for local recurrence or residual nasopharyngeal cancer and secondary cancer in the nasopharynx. Because of the anatomical complexity of the nasopharynx, the approach is limited and it is also difficult to secure a sufficient margin. We report a case of radiation-induced sarcoma that occurred 14 years after chemoradiotherapy as the initial treatment for nasopharyngeal cancer. The tumor, which arose from the superior and posterior wall of the nasopharynx, was resected via the transpalatal approach with mandibular swing combined with nasal endoscopy. By inserting instruments from two insertion paths, we obtained a good field of view and operability.Previous reports about salvage surgery for nasopharyngeal malignant tumors have been limited in Japan; this procedure is considered to be a useful approach to the nasopharynx.