Local recurrence of nasopharyngeal carcinoma with normal mucous membrane after radiation therapy: MR imaging findings]

OBJECTIVE: The purpose of this work was to investigate and analyze the MR imaging features of postradiation local recurrence of nasopharyngeal carcinoma (NPC) with normal mucous membrane. METHODS: 24 such cases were studied. The diagnosis of NPC recurrence was pathologically confirmed in 15 patients, and was corroborated by repeated radiation therapy and serial follow-ups in 9 patients. MR imaging routine procedures and Gd-DTPA enhancement were performed for all patients. RESULTS: The MR imaging findings were as follows: 1. The recurrent tumor mass was located in the prestyloid space in 8 patients, with skull base erosion and intracranial infiltration in 7 patients; 2. Retrostyloid space recurrence in 2 patients; 3. Direct bony erosion of the skull base in 7 patients; 4. Recurrence in nasal cavity and ethmoid sinuses in 3 patients; 5. Submucous cystic recurrence in 2 patients; 6. Mixed patterns of recurrence in 2 patients. Except 2 cases of cystic tumor recurrence, all cases exhibited slight hypo- or iso-intensity on T1-weighted images, slight hyper-intensity on T2-weighted images, and moderate to marked enhancement after Gd-DTPA administration. CONCLUSION: There are several special patterns of local NPC tumor recurrence after radiation therapy in the presence of normal nasopharyngeal mucosa. MR imaging is the method of choice to depict the location and extent of NPC tumor recurrence.