Rare glandular tumors of the nasopharynx: A retrospective cohort study of papillary adenocarcinoma and salivary gland–type carcinomas

Nasopharyngeal papillary adenocarcinomas (NPAC) and salivary gland-type nasopharyngeal carcinomas (SGNPCs) are rare tumors, accounting for approximately 0.38 to 0.48% of all nasopharyngeal malignancies. These tumors exhibit distinct clinical and pathological features and require different management approaches compared with conventional nasopharyngeal carcinoma. Given the limited literature, we conducted a retrospective study of 20 patients diagnosed with NPAC or SGNPC at our institution to summarize their clinical characteristics, treatment modalities, and outcomes. This retrospective study included 20 patients with pathologically confirmed NPAC or SGNPC treated at the Vietnam National Cancer Hospital from January 2019 to January 2026. A total of 20 patients were included, comprising 12 patients with NPAC and 8 patients with SGNPC. Tumors were mainly located at the roof or posterior margin of the nasopharynx, and most patients presented with early-stage disease (T1-T2) without cervical lymph node metastasis. All patients underwent endoscopic endonasal surgery, 6 patients were treated with surgery alone, while the remaining patients received postoperative radiotherapy using intensity-modulated radiation therapy. Postoperative complications were generally mild, including minor bleeding in one patient (5%) and dermatitis in all patients who received radiotherapy (100%). The median follow-up was 49.7 months (range, 4.5-84.0 months). The estimated 3-year and 5-year overall survival and disease-free survival rates were both 100% (95% confidence interval, 83.2-100%). Primary nasopharyngeal adenocarcinoma and salivary gland-type carcinoma are rare entities. In this cohort, the majority of patients presented at an early stage, and surgical intervention was the mainstay of treatment with favorable outcomes. However, these findings should be interpreted with caution given the small sample size and the surgically selected, early-stage nature of this cohort, and should be considered hypothesis-generating rather than definitive. Further prospective studies with larger patient populations and longer follow-up are needed to better define optimal treatment strategies and long-term outcomes for these rare tumors.