DOI QR코드

DOI QR Code

Incidental finding of an extensive oropharyngeal mass in magnetic resonance imaging of a patient with temporomandibular disorder: A case report

  • Omolehinwa, Temitope T. (Department of Oral Medicine, School of Dental Medicine, University of Pennsylvania) ;
  • Mupparapu, Mel (Department of Oral Medicine, School of Dental Medicine, University of Pennsylvania) ;
  • Akintoye, Sunday O. (Department of Oral Medicine, School of Dental Medicine, University of Pennsylvania)
  • Received : 2016.04.23
  • Accepted : 2016.08.11
  • Published : 2016.12.31

Abstract

In this report, we describe the incidental finding of an oropharyngeal mass in a patient who presented with a chief complaint of temporomandibular pain. The patient was initially evaluated by an otorhinolaryngologist for complaints of headaches, earache, and sinus congestion. Due to worsening headaches and trismus, he was further referred for the management of temporomandibular disorder. The clinical evaluation was uneventful except for limited mouth opening (trismus). An advanced radiological evaluation using magnetic resonance imaging revealed a mass in the nasopharyngeal/oropharyngeal region. The mass occupied the masticatory space and extended superioinferiorly from the skull base to the mandible. A diagnostic biopsy of the lesion revealed a long­standing human papilloma virus (HPV­16)­positive squamous cell carcinoma of the oropharynx. This case illustrates the need for the timely radiological evaluation of seemingly innocuous orofacial pain.

Keywords

References

  1. Grosskopf CC, Kuperstein AS, O'Malley BW Jr, Sollecito TP. Parapharyngeal space tumors: another consideration for otalgia and temporomandibular disorders. Head Neck 2013; 35: E153-6. https://doi.org/10.1002/hed.22005
  2. Reiter S, Gavish A, Emodi-Perlman A, Eli I. Nasopharyngeal carcinoma mimicking a temporomandibular disorder: a case report. J Orofac Pain 2006; 20: 74-81.
  3. Lewis A, Kang R, Levine A, Maghami E. The new face of head and neck cancer: the HPV epidemic. Oncology (Williston Park) 2015; 29: 616-26.
  4. Omolehinwa TT, Musbah T, Desai B, O'Malley BW Jr, Stoopler ET. Neuralgia associated with transcutaneous electrical nerve stimulation therapy in a patient initially diagnosed with temporomandibular disorder. Oral Surg Oral Med Oral Pathol Oral Radiol 2015; 119: e101-4. https://doi.org/10.1016/j.oooo.2014.12.015
  5. Sari-Rieger A, Hassfeld S, Junker K, Rustemeyer J. Adenoid cystic carcinoma of the skull base mimicking temporomandibular disorder. Oral Maxillofac Surg 2014; 18: 115-8. https://doi.org/10.1007/s10006-013-0414-5
  6. Schneider A, Forstner R. The value of MRI in imaging malignant head and neck tumours. Imaging Decis MRI 2007; 11: 3-10.
  7. Lee A, Fan LT, Gin T, Karmakar MK, Ngan Kee WD. A systematic review (meta-analysis) of the accuracy of the Mallampati tests to predict the difficult airway. Anesth Analg 2006; 102: 1867-78. https://doi.org/10.1213/01.ane.0000217211.12232.55
  8. Chaturvedi AK, Engels EA, Pfeiffer RM, Hernandez BY, Xiao W, Kim E, et al. Human papillomavirus and rising oropharyngeal cancer incidence in the United States. J Clin Oncol 2011; 29: 4294-301. https://doi.org/10.1200/JCO.2011.36.4596
  9. Lewis JS Jr, Thorstad WL, Chernock RD, Haughey BH, Yip JH, Zhang Q, et al. p16 positive oropharyngeal squamous cell carcinoma: an entity with a favorable prognosis regardless of tumor HPV status. Am J Surg Pathol 2010; 34: 1088-96. https://doi.org/10.1097/PAS.0b013e3181e84652
  10. Chen RC, Khorsandi AS, Shatzkes DR, Holliday RA. The radiology of referred otalgia. AJNR Am J Neuroradiol 2009; 30: 1817-23. https://doi.org/10.3174/ajnr.A1605
  11. Pitiyage G, Lei M, Guererro Urbano T, Odell E, Thavaraj S. Biphenotypic human papillomavirus-associated head and neck squamous cell carcinoma: a report of two cases. Diagn Pathol 2015; 10: 97. https://doi.org/10.1186/s13000-015-0334-9
  12. Hennessey PT, Westra WH, Califano JA. Human papillomavirus and head and neck squamous cell carcinoma: recent evidence and clinical implications. J Dent Res 2009; 88: 300-6. https://doi.org/10.1177/0022034509333371
  13. Deschler DG, Richmon JD, Khariwala SS, Ferris RL, Wang MB. The "new" head and neck cancer patient-young, nonsmoker, nondrinker, and HPV positive: evaluation. Otolaryngol Head Neck Surg 2014; 151: 375-80. https://doi.org/10.1177/0194599814538605
  14. Lorincz BB, Jowett N, Knecht R. Decision management in transoral robotic surgery: indications, individual patient selection, and role in the multidisciplinary treatment for head and neck cancer from a European perspective. Head Neck 2016; 38 Suppl 1: E2190-6. https://doi.org/10.1002/hed.24059
  15. Agulnik M, Epstein JB. Nasopharyngeal carcinoma: current management, future directions and dental implications. Oral Oncol 2008; 44: 617-27. https://doi.org/10.1016/j.oraloncology.2007.08.003
  16. Fischer DJ, Klasser GD, Epstein JB. Cancer and orofacial pain. Oral Maxillofac Surg Clin North Am 2008; 20: 287-301. https://doi.org/10.1016/j.coms.2007.12.011
  17. Kamran SC, Riaz N, Lee N. Nasopharyngeal carcinoma. Surg Oncol Clin N Am 2015; 24: 547-61. https://doi.org/10.1016/j.soc.2015.03.008
  18. Khan J, Quek SY, Markman S. Nasopharyngeal carcinoma masquerading as TMJ orofacial pain. Quintessence Int 2010; 41: 387-9.

Cited by

  1. Clinical diagnostic guidelines of allergic rhinitis: comprehensive treatment and consideration of special circumstances vol.60, pp.3, 2016, https://doi.org/10.5124/jkma.2017.60.3.257
  2. Masticator Space Tumor Mimicking Temporomandibular Disorder Presenting Facial Swelling and Trismus: A Case Report vol.44, pp.2, 2016, https://doi.org/10.14476/jomp.2019.44.2.65