Spontaneous pneumocephalus in nasopharyngeal cancer: a report of two cases and review of literature

Occurrence of pneumocephalus in nasopharyngeal cancer (NPC) is rare. To date, there were only five single-case reports in literature. We here report two additional cases. Both patients were male, aged 35 and 49. They presented initially as advanced disease with intracranial invasion, and received a full course of radiotherapy. Spontaneous pneumocephalus developed after tumor recurrence. Clinical course of the two patients was subacute. Both survived 3 months after the onset of pneumocephalus. It is speculated that local recurrence following high-dose irradiation and associated osteoradionecrosis of the base of the skull are possible factors predisposing to the development of this rare complication.