Analytical aspects of symptoms of nasopharyngeal malignancies.

The various symptoms of 766 patients with nasopharyngeal malignancies (641 carcinomas and 125 malignant lymphomas, confirmed histologically) were analysed statistically from the viewpoint of early diagnosis. These can be divided into aural, nasal, pharyngeal, ophthalmic, cervical lymph node and cranial nerve symptoms. The frequencies of these symptoms were compared in patients with tumours of different histopathological classifications: the nasopharyngeal malignancies were divided into carcinoma and malignant lymphoma, and the carcinomas were subclassified according to their degree of differentiation. On the whole, lymphoma patients more often had nasal and pharyngeal symptoms, and carcinoma patients ophthalmic and cranial nerve symptoms. It is considered that this difference is due to the different ways in which the two kinds of tumour develop. The frequencies of the symptoms naturally increased with the clinical course of the disease; the frequencies of the symptom both as an initial sign and as observed during the clinical course of the disease were examined. Nasopharyngeal malignancies are not indicated by localized symptoms but become evident when adjoining organs, such as the ear or nose, give some sign of abnormality. In not a few cases, a neck swelling is the initial sign; and in some patients, cranial nerve involvement is the first symptom. Since a patient may not understand the significance of his symptom and may consult a general surgeon, physician, ophthalmologist and/or paediatrician, these specialists should be alerted to the recognition of this disease.