Nasopharyngeal carcinoma with pterygopalatine fossa involvement

Case contributed by Paul Simkin
Diagnosis almost certain

Presentation

Right sided facial pain.

Patient Data

Age: 45
Gender: Male
This study is a stack
Axial C+ portal
venous phase
This study is a stack
Coronal C+ portal
venous phase
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Info

While subtle, there is thickening of the posterior nasopharyngeal wall on the right side. This is associated with opacification of the right mastoid air cells. A salient feature in this case is soft tissue replacement of the normal right pterygopalatine fossa, which is slightly enlarged. Note the normal left side.

This study is a stack
Axial
T2
This study is a stack
Axial
FLAIR
This study is a stack
Coronal
T2
This study is a stack
Axial
T1
This study is a stack
Coronal
T1
This study is a stack
Axial T1
C+ fat sat
This study is a stack
Coronal T1
C+ fat sat
Download
Info

An enhancing soft tissue mass in seen in the right nasopharyngeal cavity. Tumor extends into the right nasopharyngeal cavity, and then intracranially via foramen rotundum and the Vidian canal. There is also extension into the posterior orbit via the inferior orbital fissure.

Enlarged bilateral retropharyngeal lymph nodes, and right posterior triangle lymph nodes, are demonstrated.

Case Discussion

The diagnosis of nasopharyngeal carcinoma was proven by pathology.

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