{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T13:47:50Z","timestamp":1785764870331,"version":"3.56.0"},"reference-count":11,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","license":[{"start":{"date-parts":[[2026,1,20]],"date-time":"2026-01-20T00:00:00Z","timestamp":1768867200000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction and Importance:<\/jats:title>\n                    <jats:p>Nasopharyngeal carcinoma (NPC) is an epithelial malignancy of the nasopharyngeal mucosa, most often arising in the fossa of Rosenm\u00fcller. While exceedingly rare in children under 10\u00a0years, it shows a male predominance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case presentation:<\/jats:title>\n                    <jats:p>A 9-year-old male presented with bilateral cervical lymphadenopathy persisting for 1 year. Initially, unilateral right-sided neck swelling progressed to bilateral involvement with a left-sided mass. Trucut biopsy showed features consistent with Kimura disease. Repeat ultrasound-guided lymph node biopsy revealed an Epstein\u2013Barr virus (EBV)-positive non-keratinizing metastatic carcinoma, suggestive of NPC, further confirmed by immunohistochemical analysis. Treatment with neoadjuvant platinum-based chemotherapy, followed by radiotherapy, achieved a complete clinical response at 6 months.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical Discussion:<\/jats:title>\n                    <jats:p>\n                      This case demonstrates a critical diagnostic pitfall where pediatric NPC initially masqueraded as Kimura disease due to inflammatory-predominant tissue sampling. The diagnostic breakthrough came through repeat ultrasound-guided biopsy with comprehensive immunohistochemical analysis and EBV-encoded RNA\n                      <jats:italic toggle=\"yes\">in situ<\/jats:italic>\n                      hybridization, confirming EBV-positive non-keratinizing NPC. Multimodal imaging (CT\/MRI\/PET) established T2N3M0 staging. After neoadjuvant platinum-based chemotherapy followed by conformal radiotherapy, a complete clinical response at 6 months was achieved. In resource-limited settings, prioritizing repeat targeted biopsy, tissue-based EBV detection, and conformal radiotherapy offers an effective diagnostic and therapeutic pathway for this rare but treatable childhood malignancy.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>In a resource-limited setting like Nepal, for the early diagnosis and treatment of NPC, a combination of novel testing methods and a high index of suspicion in a patient with unilateral or bilateral neck swelling is necessary.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1097\/rc9.0000000000000043","type":"journal-article","created":{"date-parts":[[2026,1,20]],"date-time":"2026-01-20T09:00:07Z","timestamp":1768899607000},"page":"154-158","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["A pediatric nasopharyngeal carcinoma masquerading as Kimura disease: a rare case report from Nepal"],"prefix":"10.1097","volume":"138","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-7854-3465","authenticated-orcid":false,"given":"Sagar","family":"Mandal","sequence":"first","affiliation":[{"name":"Tribhuvan University Teaching Hospital, Maharajgunj, Kathmandu, Nepal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anuj","family":"Pant","sequence":"additional","affiliation":[{"name":"Tribhuvan University Teaching Hospital, Maharajgunj, Kathmandu, Nepal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abhishek Kumar","family":"Shah","sequence":"additional","affiliation":[{"name":"Tribhuvan University Teaching Hospital, Maharajgunj, Kathmandu, Nepal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shankar","family":"Paudel","sequence":"additional","affiliation":[{"name":"Tribhuvan University Teaching Hospital, Maharajgunj, Kathmandu, Nepal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bishal","family":"Panthi","sequence":"additional","affiliation":[{"name":"Tribhuvan University Teaching Hospital, Maharajgunj, Kathmandu, Nepal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bipashwi Ratna","family":"Shakya","sequence":"additional","affiliation":[{"name":"Department of ENT \u2013 Head & Neck Surgery (ENT-HNS), Tribhuvan University Teaching Hospital, Kathmandu, Nepal"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,1,20]]},"reference":[{"key":"R1-20260803","doi-asserted-by":"crossref","first-page":"64\u201380","DOI":"10.1016\/S0140-6736(19)30956-0","article-title":"Nasopharyngeal carcinoma","volume":"394","author":"Chen","year":"2019","journal-title":"Lancet"},{"key":"R2-20260803","doi-asserted-by":"crossref","first-page":"101890","DOI":"10.1016\/j.ctrv.2019.101890","article-title":"Management of locally recurrent nasopharyngeal carcinoma","volume":"79","author":"Lee","year":"2019","journal-title":"Cancer Treat Rev"},{"key":"R3-20260803","doi-asserted-by":"crossref","first-page":"452\u201365","DOI":"10.1016\/j.annonc.2020.12.007","article-title":"ESMO Guidelines Committee. Electronic address: clinicalguidelines@esmo.org & EURACAN. Nasopharyngeal carcinoma: ESMO-EURACAN Clinical Practice Guidelines for diagnosis, treatment and follow-up","volume":"32","author":"Bossi","year":"2021","journal-title":"Ann Oncol"},{"key":"R4-20260803","first-page":"1138\u201366","article-title":"Recurrent\/metastatic nasopharyngeal carcinoma treatment from present to future: Where are we and where are we heading?","volume":"24","author":"Juarez-Vignon Whaley","year":"2023","journal-title":"Curr Treat Options Oncol"},{"key":"R5-20260803","doi-asserted-by":"crossref","first-page":"F1000","DOI":"10.12688\/f1000research.15066.1","article-title":"Recent advances in the management of nasopharyngeal carcinoma","volume":"7","author":"Lam","year":"2018","journal-title":"F1000Res"},{"key":"R7-20260803","first-page":"1\u201325","article-title":"Myocardial edema: importance in the study of left ventricular function","volume":"5","author":"Spotnitz","year":"1994","journal-title":"Adv Card Surg"},{"key":"R9-20260803","doi-asserted-by":"crossref","first-page":"277\u201383","DOI":"10.1021\/acsabm.8b00595","article-title":"Super mechanical stimuli responsive hydrogel: Dynamic cues for cell applications","volume":"2","author":"Kollarigowda","year":"2019","journal-title":"ACS Applied Bio Materials"},{"key":"R10-20260803","article-title":"The role of PET\/CT in radiotherapy for nasopharyngeal carcinoma","volume":"12","author":"Li","year":"2022","journal-title":"Front Oncol"},{"key":"R11-20260803","doi-asserted-by":"crossref","first-page":"6508","DOI":"10.3390\/jcm14186508","article-title":"Predictive Value of [18F]FDG PET\/CT for Neoadjuvant Chemoradiotherapy Response in Nasopharyngeal Carcinoma","volume":"14","author":"Quartuccio","year":"2025","journal-title":"J Clin Med"},{"key":"R12-20260803","first-page":"1138\u201366","article-title":"Recurrent\/metastatic nasopharyngeal carcinoma treatment from present to future: Where are we and where are we heading?","volume":"24","author":"Whaley","year":"2023","journal-title":"Curr Treat Options Oncol"},{"key":"R13-20260803","first-page":"2681\u201389","article-title":"Advanced nasopharyngeal carcinoma: Current and emerging treatment options","volume":"14","author":"Iromaru","year":"2022","journal-title":"Cancer Manag Res"}],"container-title":["International Journal of Surgery Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.1097\/RC9.0000000000000043","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T13:06:46Z","timestamp":1785762406000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.1097\/RC9.0000000000000043"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,20]]},"references-count":11,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2026]]}},"URL":"https:\/\/doi.org\/10.1097\/rc9.0000000000000043","relation":{},"ISSN":["2210-2612"],"issn-type":[{"value":"2210-2612","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,20]]},"assertion":[{"value":"2025-09-06","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-11-26","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}