Primary nasopharyngeal carcinoma with cerebrospinal fluid EBV positivity: A case report and mini literature review

Jinli Feng , Shuang Wang , Hongli Zhang, Jun Zhao, Xuling Wang
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Abstract

Background

To summarize the diagnosis and treatment of a patient with nasopharyngeal carcinoma and cerebrospinal fluid (CSF) Epstein-Barr virus (EBV) positivity (determined by next-generation sequencing), review the relevant literature, and explore the significance of EBV presence in the CSF of patients with nasopharyngeal carcinoma.

Methods

A patient presenting with headache as the initial symptom was diagnosed with nasopharyngeal carcinoma and admitted to the Eighth Medical Center of Chinese PLA General Hospital on March 3, 2021. Available databases were screened for reports on nasopharyngeal carcinoma with EBV-positive CSF and analyzed. The patients’ general information, initial symptoms, treatment, and prognosis were subsequently evaluated.

Results

EBV-positive CSF is commonly observed in patients with recurrent nasopharyngeal carcinoma. However, no reports of EBV-positive CSF in patients with primary nasopharyngeal carcinoma have been published to date.

Conclusion

The presence of EBV in the CSF of patients with recurrent nasopharyngeal carcinoma is indicative of a poor prognosis. Thus, newly diagnosed nasopharyngeal carcinoma patients should undergo a lumbar puncture as soon as possible to have their CSF tested for EBV. Such a measure would promptly predict the prognosis and facilitate the development of a personalized treatment strategy.

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原发性鼻咽癌伴脑脊液 EBV 阳性:病例报告和小型文献综述
背景概述一名鼻咽癌患者脑脊液(CSF)EB病毒(Epstein-Barr virus,EBV)阳性(通过新一代测序确定)的诊断和治疗,回顾相关文献,探讨鼻咽癌患者脑脊液中EBV存在的意义。方法2021年3月3日,中国人民解放军总医院第八医学中心收治了一名以头痛为首发症状的鼻咽癌患者。对现有数据库中关于鼻咽癌伴 EBV 阳性 CSF 的报告进行了筛选和分析。结果EBV阳性CSF常见于复发性鼻咽癌患者。结论复发性鼻咽癌患者 CSF 中出现 EBV 阳性表明预后不良。因此,新确诊的鼻咽癌患者应尽快进行腰椎穿刺,检测 CSF 中的 EBV。这样做可以及时预测预后,有助于制定个性化的治疗策略。
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