{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T04:31:36Z","timestamp":1792211496831,"version":"4.4.0"},"reference-count":15,"publisher":"BMJ","issue":"8","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2021,7,16]]},"published-print":{"date-parts":[[2021,8]]},"abstract":"<jats:p>We report a case of a male patient. He presented with nasal obstruction and epistaxis. The MRI of the brain showed a mass in the nasopharynx and enlarged cervical lymph nodes. Besides this, there was an extra-axial, dural-based lesion in brain and subcentimetre nodules in both lungs. He received induction chemotherapy followed by chemoradiation therapy to the primary site and dural-based metastatic deposit. He re-presented with bilateral lower limb weakness. The MRI of the spine showed metastatic deposits within the thoracic cord parenchyma and meningeal deposits at the lumbar region. Palliative radiation was used to treat spinal cord and meningeal metastases. He died a few months later because of systemic disease progression. Considering the rarity of this presentation in nasopharyngeal carcinoma and lack of clear guidelines for standard treatment, we report this case to share our experience of management.<\/jats:p>","DOI":"10.1136\/bcr-2021-243892","type":"journal-article","created":{"date-parts":[[2021,8,17]],"date-time":"2021-08-17T13:07:33Z","timestamp":1629205653000},"page":"e243892","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":4,"title":["Central nervous system metastases: a rare presentation of nasopharyngeal carcinoma"],"prefix":"10.1136","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1402-2203","authenticated-orcid":false,"given":"Sehrish","family":"Abrar","sequence":"first","affiliation":[{"name":"Radiation Oncology, Aga Khan University Hospital, Karachi, Sindh, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nasir","family":"Ali","sequence":"additional","affiliation":[{"name":"Radiation Oncology, Aga Khan University Hospital, Karachi, Sindh, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0138-7628","authenticated-orcid":false,"given":"Bilal Mazhar","family":"Qureshi","sequence":"additional","affiliation":[{"name":"Radiation Oncology, Aga Khan University Hospital, Karachi, Sindh, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rabia","family":"Tahseen","sequence":"additional","affiliation":[{"name":"Radiation Oncology, Aga Khan University Hospital, Karachi, Sindh, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2021,8,17]]},"reference":[{"key":"2025082702094931000_14.8.e243892.1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21492"},{"key":"2025082702094931000_14.8.e243892.2","doi-asserted-by":"crossref","first-page":"109","DOI":"10.14740\/wjon980w","article-title":"Incidence and mortality of nasopharynx cancer and its relationship with human development index in the world in 2012","volume":"7","author":"Mahdavifar","year":"2016","journal-title":"World J Oncol"},{"key":"2025082702094931000_14.8.e243892.3","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.31937"},{"key":"2025082702094931000_14.8.e243892.4","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/djs320"},{"key":"2025082702094931000_14.8.e243892.5","doi-asserted-by":"crossref","first-page":"398","DOI":"10.1002\/cncr.10179","article-title":"Central nervous system metastasis from nasopharyngeal carcinoma: a report of two patients and a review of the literature","volume":"94","author":"Ngan","year":"2002","journal-title":"Cancer"},{"key":"2025082702094931000_14.8.e243892.6","doi-asserted-by":"publisher","DOI":"10.1007\/s00701-004-0386-1"},{"key":"2025082702094931000_14.8.e243892.7","doi-asserted-by":"publisher","DOI":"10.1016\/S0009-9260(78)80160-3"},{"key":"2025082702094931000_14.8.e243892.8","doi-asserted-by":"publisher","DOI":"10.1093\/jjco\/hyi245"},{"key":"2025082702094931000_14.8.e243892.9","unstructured":"National comprehensive cancer network, 2019. 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