METASTATIC SPREAD AND SKLETAL DISSEMINATION IN NASOPHARYNGEAL CANCER

The files of 167 untreated nasopharyngeal carcinoma patients were reviewed. 39 of them had metastatic spread. Dessemination was more frequent in nodally positive patients. 69% of the metastases was observed during the first year. Mostly affected metastatic site was the skeletal system (72%) followed by the lungs (26%) and the liver (21%). The pattern of skeletal involvement conforming to the general pattern showed dorsal and lumbar spine were the commonest involved bones, beign involved by (32%) and (22%) respectively. Sacral spine (15%) and pelvic bones (11%) were also frequently attacked. Radiologically the lesions were lytic in 75%, mixed (lytic and sclerotic) in 18% and multiple in 6%. 39% of the lytic lesions had miliary radiologic appearance.