A Rare Coincidence of Non-keratinizing Nasopharyngeal Squamous Cell Carcinoma (SCC) and Pituitary Adenoma: A Case Report

Simin  Soltaninejad; Samira  Yazdani; Mojgan  Sanjari; Maryam  Bahador

doi:10.18502/crcp.v10i2.19897

Simin Soltaninejad Department of Radiotherapy Oncology, Afzalipour Hospital, Kerman University of Medical Sciences, Kerman, Iran
Samira Yazdani Department of Medical Physics, Shafa Hospital, Kerman University of Medical Sciences, Kerman, Iran.
Mojgan Sanjari Endocrinology and Metabolism Research Center, Institute of Basic and Clinical Physiology Sciences, Kerman University of Medical Sciences, Kerman, Iran
Maryam Bahador Department of Radiotherapy Oncology, Afzalipour Hospital, Kerman University of Medical Sciences, Kerman, Iran

DOI: https://doi.org/10.18502/crcp.v10i2.19897

Keywords: Nasopharyngeal neoplasms; Pituitary adenoma; Radiotherapy

Abstract

This is the first reported case of the coexistence of nasopharyngeal carcinoma and pituitary adenoma in a 36-year-old female. The case is significant due to the rarity of these two tumors occurring simultaneously and the diagnostic challenges posed by overlapping symptoms. The patient presented with a history of chronic nocturnal headaches localized to the temporal region. Initial symptoms included six months of amenorrhea, massive bilateral galactorrhea, and classic clinical signs of acromegaly. The nasopharyngeal mass was initially missed during early evaluations, as the patient was primarily assessed for a secreting pituitary adenoma. The nasopharyngeal mass was detected for the first time during rhinoplasty using an endoscope. Histopathological examination confirmed differentiated non- keratinizing nasopharyngeal carcinoma alongside a pituitary adenoma. During radiotherapy for the nasopharyngeal carcinoma, the patient developed visual symptoms, including ptosis and outward deviation of the eye. The patient declined surgical excision of the pituitary adenoma; therefore, the radiotherapy field was expanded to include the adenoma. The radiotherapy dose was 70 Gy, delivered in 35 sessions. After three months of expanded radiotherapy, all symptoms, including headaches and visual disturbances, were completely resolved. Follow-up after 14 months showed no evidence of recurrence or disease progression.