{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T00:04:45Z","timestamp":1756339485969,"version":"3.44.0"},"reference-count":13,"publisher":"BMJ","issue":"7","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2019,6,3]]},"published-print":{"date-parts":[[2019,7]]},"abstract":"<jats:p>Sarcomatoid carcinoma is a rare clinical entity, especially when presenting in the nasopharynx. We describe the first documented case of nasopharyngeal sarcomatoid carcinoma with intracranial extension in a 59-year-old Caucasian man presenting with severe bifrontal headache and diplopia, secondary to left abducens nerve palsy. We highlight some of the major diagnostic challenges and describe its unusual histological appearance. We outline the importance of a multidisciplinary approach to his management, which includes input from the medicine, neurosurgery, Ear, Nose and Throat (ENT), pathology, radiology, oncology and respiratory teams. In the context of limited evidence, we then describe the rationale to proceed with induction chemotherapy followed by concurrent chemoradiotherapy. Although there was a partial response to treatment, it was not sufficient enough to allow subsequent surgical clearance. The plan going forward is to palliate with chemotherapy as and when the disease progresses.<\/jats:p>","DOI":"10.1136\/bcr-2018-226168","type":"journal-article","created":{"date-parts":[[2019,7,9]],"date-time":"2019-07-09T06:09:12Z","timestamp":1562652552000},"page":"e226168","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["A challenging presentation of invasive nasopharyngeal sarcomatoid carcinoma"],"prefix":"10.1136","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9143-8942","authenticated-orcid":false,"given":"Alexander","family":"Yao","sequence":"first","affiliation":[{"name":"Department of Otolaryngology, Stockport NHS Foundation Trust, Stockport, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Haroon","family":"Saeed","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, Stockport NHS Foundation Trust, Stockport, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gavin","family":"Udall","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, Stockport NHS Foundation Trust, Stockport, UK"},{"name":"Department of Pathology, Stockport NHS Foundation Trust, Stockport, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vivek","family":"Kaushik","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, Stockport NHS Foundation Trust, Stockport, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lip Wai","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Clinical Oncology, The Christie NHS Foundation Trust, Manchester, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2019,7,8]]},"reference":[{"key":"2025082708055801000_12.7.e226168.1","doi-asserted-by":"crossref","DOI":"10.1186\/s12885-017-3059-1","article-title":"Stepwise addition of genetic changes correlated with histological change from \"well-differentiated\" to \"sarcomatoid\" phenotypes: a case report","volume":"17","author":"Goto","year":"2017","journal-title":"BMC Cancer"},{"key":"2025082708055801000_12.7.e226168.2","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1186\/s40880-016-0103-5","article-title":"A new prognostic histopathologic classification of nasopharyngeal carcinoma","volume":"35","author":"Wang","year":"2016","journal-title":"Chin J Cancer"},{"key":"2025082708055801000_12.7.e226168.3","doi-asserted-by":"crossref","first-page":"200","DOI":"10.1016\/j.amjoto.2014.10.031","article-title":"A case-control analysis of survival outcomes in sinonasal carcinosarcoma","volume":"36","author":"Patel","year":"2015","journal-title":"Am J Otolaryngol"},{"key":"2025082708055801000_12.7.e226168.4","doi-asserted-by":"crossref","first-page":"2709","DOI":"10.1002\/lary.25383","article-title":"Laryngeal spindle cell carcinoma: a population-based analysis of incidence and survival","volume":"125","author":"Dubal","year":"2015","journal-title":"Laryngoscope"},{"key":"2025082708055801000_12.7.e226168.5","first-page":"428","article-title":"A rare case of nasopharyngeal carcinosarcoma","volume":"67","author":"Lim","year":"2012","journal-title":"Med J Malaysia"},{"key":"2025082708055801000_12.7.e226168.6","doi-asserted-by":"crossref","first-page":"164","DOI":"10.1007\/BF02994134","article-title":"Spindle cell carcinoma of the nasopharynx","volume":"38","author":"Singh","year":"1986","journal-title":"Indian J Otolaryngol"},{"key":"2025082708055801000_12.7.e226168.7","doi-asserted-by":"crossref","first-page":"e34","DOI":"10.1097\/PAS.0b013e3182159dec","article-title":"Sarcomatoid carcinoma of the urinary bladder: the final common pathway of urothelial carcinoma dedifferentiation","volume":"35","author":"Cheng","year":"2011","journal-title":"Am J Surg Pathol"},{"doi-asserted-by":"publisher","key":"2025082708055801000_12.7.e226168.8","DOI":"10.1002\/(SICI)1097-0142(19990815)86:4<608::AID-CNCR9>3.0.CO;2-1"},{"key":"2025082708055801000_12.7.e226168.9","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1002\/alr.21418","article-title":"Sinonasal squamous cell carcinoma and the prognostic implications of its histologic variants: a population-based study","volume":"5","author":"Vazquez","year":"2015","journal-title":"Int Forum Allergy Rhinol"},{"key":"2025082708055801000_12.7.e226168.10","doi-asserted-by":"crossref","first-page":"1310","DOI":"10.1200\/JCO.1998.16.4.1310","article-title":"Chemoradiotherapy versus radiotherapy in patients with advanced nasopharyngeal cancer: phase III randomized Intergroup study 0099","volume":"16","author":"Al-Sarraf","year":"1998","journal-title":"J Clin Oncol"},{"doi-asserted-by":"publisher","key":"2025082708055801000_12.7.e226168.11","DOI":"10.1056\/NEJMoa070956"},{"doi-asserted-by":"publisher","key":"2025082708055801000_12.7.e226168.12","DOI":"10.1016\/j.radonc.2009.04.014"},{"key":"2025082708055801000_12.7.e226168.13","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1016\/j.radonc.2018.02.027","article-title":"Induction chemotherapy for locally advanced nasopharyngeal carcinoma treated with concurrent chemoradiation: a systematic review and meta-analysis","volume":"129","author":"Tan","year":"2018","journal-title":"Radiother Oncol"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2018-226168","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T15:06:06Z","timestamp":1756307166000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2018-226168"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,7]]},"references-count":13,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2019,7,8]]},"published-print":{"date-parts":[[2019,7]]}},"alternative-id":["10.1136\/bcr-2018-226168"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2018-226168","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2019,7]]}}}