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Nasopharyngeal adenoid cystic carcinoma (NACC) is a rare malignancy with high local invasiveness. To date, there is no consensus on the imaging characteristics of NACC. To address this, we retrospectively reviewed 10 cases of NACC and summarized the magnetic resonance imaging (MRI) features. MR images of 10 patients with histologically validated NACC were reviewed by two experienced radiologists. The location, shape, margin, signal intensity, lesion texture, contrast enhancement patterns, local invasion, and cervical lymphadenopathy of all tumors were evaluated. Clinical and pathologic records were also reviewed. No patients were positive for antibodies against Epstein-Barr virus (EBV). The imaging patterns of primary tumors were classified into two types as determined by location, shape, and margin. Of all patients, 7 had tumors with a type 1 imaging pattern and 3 had tumors with a type 2 imaging pattern. The 4 tubular NACCs were all homogeneous tumors, whereas 3 (60%) of 5 cribriform NACCs and the sole solid NACC were heterogeneous tumors with separations or central necrosis on MR images. Five patients had perineural infiltration and intracranial involvement, and only 2 had cervical lymphadenopathy. Based on these results, we conclude that NACC is a local, aggressive neoplasm that is often negative for EBV infection and associated with a low incidence of cervical lymphadenopathy. Furthermore, MRI features of NACC vary in locations and histological subtypes.

Objective: To evaluate bony changes in the skull base after radiotherapy by computed tomography (CT) and their correlation with local recurrence in patients with nasopharyngeal carcinoma (NPC) without previous involvement of the skull base., Design: Retrospective study., Setting: Sun-Yat Sen University Cancer Center., Methods: The records of 80 patients with NPC during the period from January 1992 to December 2005 were reviewed. All patients had been treated with radical radiotherapy or chemoradiotherapy at standard doses and were followed up with plain and contrast-enhanced CT every 6 months for 45.5 (range 12-108) months., Main Outcome Measures: The types, areas, time of the first occurrence after radiotherapy and development of the postradiation bony changes of the skull base, and local recurrence rates of NPC were measured., Results: Eighteen patients (22.5%) had sclerosis in some area of the skull base, and the sclerosis in 5 (27.8%) of these patients changed into osteoporosis in 1 to 5 years after its appearance. Seventeen patients (21.3%) had osteolysis. The local recurrence rate of patients with osteolysis was observed to be significantly higher than that of patients with sclerosis (p < .0001)., Conclusions: The appearance of osteolytic changes in the skull base during follow-up of patients with NPC who had normal skull base morphology before treatment was associated with tumour recurrence.