EB Virus, Nasopharyngeal Cancer, and Ear Tumor Concerns

EB virus is associated with nasopharyngeal carcinoma and tumors located behind the earlobe?

Hello Dr.
Chen,
First of all, thank you for your professional and attentive response.
Here are my questions:
1.
Last year during my health check-up, my Epstein-Barr virus (EBV) test was suspected to be positive.
Later, I went to the hospital for a re-examination, and the EBV test result fell into the yellow zone, which should be considered a false positive.
I also underwent a nasal endoscopy, and no tumors were found.
The doctor advised me to return for a follow-up in three months.
I would like to ask, if I go for the follow-up and the nasal endoscopy shows no abnormalities, does that mean I have only had a past EBV infection and not developed nasopharyngeal carcinoma? I found online that EBV can remain latent in lymphocytes, so if I test for EBV again in the future, will the antibodies never decrease to normal (negative) levels? If EBV indeed increases the risk of nasopharyngeal carcinoma, how often should I undergo nasal endoscopy each year?
2.
My father has a small lump behind his earlobe that has not changed in size for several years, but recently it seems to have grown slightly, so he went to the hospital for an examination.
He directly consulted a plastic surgeon, and after evaluation, the doctor decided to remove the lump and check whether it is benign or malignant.
The report should be available this week.
My question is, should my father have initially seen an otolaryngologist for a nasal endoscopy? I found online that nasopharyngeal carcinoma can present with symptoms similar to what my father is experiencing.
If it turns out to be a benign tumor, should he still have his nasal cavity checked for abnormalities? I am curious how doctors typically handle cases of tumors near the ear and whether the likelihood of cancer is high in such cases.
To be honest, I am very concerned about my father's health.
Thank you for your response.

Mr. Huang, 20~29 year old female. Ask Date: 2010/04/05

Dr. Chen Jianzhi reply Otolaryngology

Dear Inquirer,
Based on your literal question, I have carefully read and provide the following response:
1.
Individuals who have been infected with the Epstein-Barr virus (EBV) will have a lifelong positive result for EB IgG; however, EB IgA does not follow this pattern.
Most patients with nasopharyngeal carcinoma will test positive for EB IgA, while healthy individuals will test negative.
Given your medical history, which has raised some concerns, I recommend that you retest your EB IgA antibodies and consider a biopsy of the nasopharyngeal area to clarify any uncertainties between you and your healthcare provider.
2.
I suggest that your father undergo a nasopharyngeal examination.
Once the definitive pathology report is available, could you please revisit this platform to discuss it further?
Sincerely,
Dr.
Chien-Chih Chen, Physician at Taoyuan Hospital, Department of Health, and Lecturer at Fu Jen Catholic University

Reply Date: 2010/04/05

More Info

Understanding the relationship between the Epstein-Barr Virus (EBV), nasopharyngeal cancer, and ear tumors is crucial for both prevention and detection. Your concerns are valid, especially given the complexities surrounding EBV and its potential implications for health.

1. EBV and Nasopharyngeal Cancer
EBV is a member of the herpesvirus family and is known to be associated with several diseases, including nasopharyngeal carcinoma (NPC). Once a person is infected with EBV, the virus remains in the body for life, typically in a dormant state within B lymphocytes. This means that while you may have had a positive test for EBV antibodies, it does not necessarily indicate active disease or cancer.
In your case, the initial positive result followed by a "yellow light" reading suggests that you may have had a past infection, which is common, as many people are exposed to EBV during childhood or adolescence. The subsequent endoscopy showing no tumors is a reassuring sign. If future endoscopies continue to show no abnormalities, it is likely that you are not developing NPC.
Regarding your question about the persistence of EBV antibodies, it is indeed true that EBV IgG antibodies remain positive for life after infection. However, the presence of EBV IgA antibodies is more indicative of an active infection or an increased risk for NPC. Therefore, if your EBV IgA levels remain low, it is a good sign.
As for the frequency of endoscopic examinations, if you have no symptoms and your previous tests are normal, annual checks may be sufficient. However, your healthcare provider may recommend more frequent monitoring based on your individual risk factors, including family history or other health concerns.

2. Concerns About Your Father's Ear Tumor
Regarding your father's situation, the growth near his ear could be a variety of benign conditions, such as a lipoma or sebaceous cyst, especially since it has been stable for years. The decision to remove the growth and perform a pathological examination is a standard approach to rule out malignancy.
While it is true that NPC can present with symptoms similar to those your father is experiencing, such as ear fullness or a mass in the neck, it is essential to consider the context. If the tumor is confirmed to be benign, further investigation of the nasopharynx may still be warranted, especially if there are any lingering concerns or symptoms.
In general, when dealing with tumors or masses in the head and neck region, an ENT specialist is often the best first point of contact. They can perform a thorough examination and determine if further imaging or endoscopic evaluation is necessary.

Conclusion
In summary, while EBV is associated with an increased risk of nasopharyngeal cancer, the presence of antibodies alone does not confirm cancer. Regular monitoring and consultations with healthcare professionals are essential for peace of mind and health management. For your father, the removal of the tumor and subsequent pathology report will provide clarity on the nature of the growth. If it is benign, routine follow-ups with an ENT specialist may be sufficient.
It's understandable to feel anxious about these health concerns, but staying informed and proactive in seeking medical advice is the best approach. Always consult with your healthcare provider for personalized recommendations based on your specific circumstances.

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