Nasopharyngeal carcinoma

Case contributed by Dr Smita Deb


Right ear pain and sore throat.

Patient Data

Age: 73
Gender: Female
  • Right sided nasopharyngeal mass (52x 41x25 mm) involving the right lateral aspect of the oropharynx with subtle mucosal thickening in the posterior wall of the right piriform sinus.
  • Extension into the infratemporal masticator space, invading the pterygoid muscles.
  • The right internal carotid artery is partially encased.
  • Direct invasion into the skull base; greater wing of sphenoid and basi-sphenoid, extending through foramen ovale into the middle cranial fossa.
  • Lobulated enhancement is seen along the floor of the middle cranial fossa and the right cavernous sinus is expanded with tumor.
  • Right mastoid effusion
  • 10mm right jugulodigastric node.

Case Discussion

Case submitted by Dr Smita Deb and A/Prof Pramit Phal.

Large right sided NPC with skull base invasion accounts for the patient's symptoms.

The sites of the nasopharynx include: vault, lateral and posterior walls, superior surface of soft palate.


T4- extensive tumor invasion in this case into the middle cranial fossa, infratemporal fossa and masticator space. T4 staging also applies if tumor involves cranial nerves, the brain, hypopharynx or orbit. 

 N1- unilateral metastasis in lymph node above the supraclavicular fossa <6cm.


The mass was biopsied and histology revealed a well differentiated keratinizing type NPC.

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Case information

rID: 31171
Published: 25th Feb 2015
Last edited: 14th Aug 2019
System: Head & Neck
Inclusion in quiz mode: Included

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