Tumor Growth: The Need for Repeated Biopsies

Q: Tumor Growth: The Need for Repeated Biopsies

Hello, internet user： Smoking itself is a risk factor for cancer (including nasopharyngeal carcinoma). <br>As you mentioned, hyperplasia of the nasopharyngeal tissue is not necessarily malignant, and benign biopsy results do not completely rule out malignancy (as it is possible t

Tumor issues

Today in April, I went to the hospital for a check-up due to nasal congestion.
The doctor said I had a deviated septum and there was a mass in the nasopharynx that needed a biopsy.
After the examination, it was determined to be benign tissue, so I proceeded with surgery for the deviated septum.
After recovery, I returned to the hospital for another check-up, and there was again a mass in the nasopharynx, leading to a second biopsy on the same day.
A week later, I returned to the hospital to review the report, which again showed benign tissue.

Three months later, I went back for another check-up and noticed signs of hyperplasia.
At that time, a third nasopharyngeal biopsy was performed, and I am now waiting for the report.

Doctor, does continuous hyperplasia mean that I need to keep having biopsies? Is there a relationship with smoking that could cause ongoing hyperplasia? I asked the doctor at that time, and he mentioned that some patients only find out they have nasopharyngeal cancer after undergoing their seventh or eighth biopsy! This leaves me puzzled—could it be that the biopsies are just missing the cancer, or should hyperplasia always raise suspicion for needing a biopsy? Thank you for your response, doctor.

honda7788, 30~39 year old female. Ask Date: 2016/09/10

Dr. Hu Ziren reply Oncology

Hello, internet user: Smoking itself is a risk factor for cancer (including nasopharyngeal carcinoma).
As you mentioned, hyperplasia of the nasopharyngeal tissue is not necessarily malignant, and benign biopsy results do not completely rule out malignancy (as it is possible that the malignant area was not sampled).
Additionally, malignancy does not only indicate problems in the nasopharynx (some cases may involve lymphatic and distant metastasis).
Therefore, the purpose of repeated biopsies and regular follow-up appointments is typically for "early detection and early treatment." I recommend discussing any concerns with your attending physician! By Dr.
Hu Zi-ren.

Reply Date: 2016/09/10

More Info

Understanding tumor growth and the necessity for repeated biopsies is a crucial aspect of managing potential malignancies, particularly in the context of your situation involving nasal and nasopharyngeal masses. The repeated biopsies you have undergone are indicative of a careful and thorough approach to monitoring any changes in the tissue that could suggest malignancy.

The Importance of Repeated Biopsies
1. Monitoring Changes: In cases where there is a persistent mass or lesion, especially in areas like the nasopharynx, repeated biopsies may be warranted to monitor for any changes in the cellular structure of the tissue. Even if initial biopsies return benign results, the nature of tumors can evolve. Tumors can exhibit different growth patterns, and what may appear benign at one point can change over time.

2. Histological Variability: Tumors can sometimes have heterogeneous characteristics, meaning that different areas of the same tumor may exhibit different histological features. This variability can lead to situations where a biopsy taken from one area may not represent the entire tumor's behavior. Therefore, if there is a suspicion of malignancy, especially with persistent symptoms or growth, additional biopsies may be necessary.

3. Clinical Judgment: Your physician's recommendation for repeated biopsies is likely based on clinical judgment, considering factors such as your symptoms, the appearance of the lesions, and any changes observed during follow-up examinations. The history of your nasal and nasopharyngeal masses, including their persistence and any signs of growth, justifies this approach.

Relationship with Smoking
Regarding your question about smoking, it is well-established that tobacco use is a significant risk factor for various head and neck cancers, including nasopharyngeal carcinoma. Smoking can lead to chronic irritation and inflammation of the mucosal surfaces, which may contribute to the development of dysplastic changes in the tissue. These changes can sometimes manifest as hyperplasia or even pre-cancerous lesions.

The Need for Vigilance
Your physician's comment about patients undergoing multiple biopsies before a diagnosis of nasopharyngeal cancer is not uncommon. It highlights the importance of vigilance in monitoring lesions that do not resolve or that exhibit growth. The process of diagnosing cancer can be complex, and sometimes it takes several evaluations to reach a definitive conclusion.

Conclusion
In summary, the need for repeated biopsies in your case is a prudent measure to ensure that any potential malignancy is detected early. While benign results are reassuring, the presence of persistent or growing lesions warrants ongoing evaluation. Smoking is a known risk factor for malignancies in the head and neck region, and it is advisable to discuss smoking cessation with your healthcare provider to reduce your risk.
It is essential to maintain open communication with your healthcare team, express your concerns, and ensure that you are comfortable with the monitoring plan. Regular follow-ups and adherence to your physician's recommendations will be key in managing your health moving forward.

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