Connective tissue disease coincident with nasopharyngeal carcinoma: Two sporadic cases in a Western population

Objectives: To increase awareness of the potential coexistence of connective tissue disease and nasopharyngeal carcinoma in a Western population, to consider possible causes for this phenomenon, and to provide recommendations for clinical management. Design: Case report. Setting: Academic tertiary referral practice. Patients: Ninety-four patients with nasopharyngeal carcinoma were initially treated, and 20 were followed for 10 years. Of these, 2 were diagnosed as having coexistent connective tissue disease. Main Outcome Measure: The clinical course of coexisting diseases. Results: Most previous reports of the coexistence of nasopharyngeal carcinoma and connective tissue disease involve southern Chinese populations. There are distinct similarities between those series and the cases presented herein. The association can take several forms with differing order of presentation and spectrum of symptoms. A variety of mechanisms have been proposed for the dual development of the 2 disease states. Conclusions: Connective tissue disease and nasopharyngeal carcinoma may coexist in white patients in a manner similar to that seen in Asian populations. Awareness of this possibility is an indication for special screening measures.