Presentation
Bilateral otitis media.
Patient Data
A large heterogeneously-enhancing soft tissue mass measuring 74 × 52 × 38 mm is seen in nasopharynx predominantly on right side, and obliterating bilateral fossa of Rosenmuller. The mass extends anteriorly into the posterior nares and superiorly invades the clivus and floor of the sphenoid sinus. Associated sphenoid & left maxillary sinusitis, and bilateral otomastoiditis are present. Enhancing enlarged bilateral cervical and parotid lympadenopathy with maximum SAD of 21 mm.
Case Discussion
Pathology proven case of nasopharyngeal carcinoma with involvement of the clivus and infero-posterior walls of the sphenoid sinus. Otitis media in an elderly patient should raise the suspicion of nasopharyngeal carcinoma.