Case Report: Pediatric nasopharyngeal carcinoma masquerading as benign lymphadenopathy: diagnostic pitfalls in two cases.

BACKGROUND

Diagnosis of pediatric nasopharyngeal carcinoma (NPC) is frequently delayed due to its rarity and histologic mimicry of benign lymphoproliferative disorders.

CASE PRESENTATION: We report two pediatric cases of NPC presenting with isolated cervical lymphadenopathy, initially misdiagnosed as Kimura disease and classical Hodgkin lymphoma, respectively. Both patients were treated with multimodal chemoradiotherapy and remain under follow-up.

CONCLUSIONS

These cases highlight the diagnostic challenges of pediatric NPC, particularly its mimicry of reactive or inflammatory conditions. Persistent cervical lymphadenopathy in children warrants early core or excisional biopsy, routine cytokeratin staining, and EBER in-situ hybridization to expedite diagnosis and optimize outcomes.