Nasopharyngeal carcinoma clinical manifestations

Written by Deng Bang Yu
Otolaryngology
Updated on September 17, 2024
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Nasopharyngeal carcinoma is the most common malignant tumor in the nasopharyngeal area, and clinically, it is primarily squamous cell carcinoma. The incidence of nasopharyngeal carcinoma is particularly high in the southern regions of China, especially in Guangdong. Initially, nasopharyngeal carcinoma manifests locally as a tumorous mass in the nasopharyngeal area, often with ulceration on the surface. This can lead to the presence of blood in nasal mucus, known as bloody nasal discharge. As the disease progresses, there can be swelling of the cervical lymph nodes, primarily involving the upper deep cervical lymph nodes, with about 60% of patients experiencing this type of lymph node enlargement. As the tumor enlarges, it may block the nasal passage, leading to persistent nasal congestion. The tumor's pressure on the Eustachian tube can cause symptoms of secretory otitis media. Furthermore, damage to the skull base by the tumor can lead to severe headaches. As a malignant tumor, the cancer can cause systemic symptoms such as malnutrition and cachexia. In advanced stages, metastatic symptoms may appear, such as bone and liver metastases, affecting these vital organs.

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Written by Deng Bang Yu
Otolaryngology
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Nasopharyngeal carcinoma clinical manifestations

Nasopharyngeal carcinoma is the most common malignant tumor in the nasopharyngeal area, and clinically, it is primarily squamous cell carcinoma. The incidence of nasopharyngeal carcinoma is particularly high in the southern regions of China, especially in Guangdong. Initially, nasopharyngeal carcinoma manifests locally as a tumorous mass in the nasopharyngeal area, often with ulceration on the surface. This can lead to the presence of blood in nasal mucus, known as bloody nasal discharge. As the disease progresses, there can be swelling of the cervical lymph nodes, primarily involving the upper deep cervical lymph nodes, with about 60% of patients experiencing this type of lymph node enlargement. As the tumor enlarges, it may block the nasal passage, leading to persistent nasal congestion. The tumor's pressure on the Eustachian tube can cause symptoms of secretory otitis media. Furthermore, damage to the skull base by the tumor can lead to severe headaches. As a malignant tumor, the cancer can cause systemic symptoms such as malnutrition and cachexia. In advanced stages, metastatic symptoms may appear, such as bone and liver metastases, affecting these vital organs.

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Written by Zhang Jun
Otolaryngology
1min 12sec home-news-image

The Difference between Nasopharyngitis and Nasopharyngeal Carcinoma

The differences between nasopharyngitis and nasopharyngeal carcinoma are very clear. Firstly, nasopharyngitis is an acute inflammatory irritation, while the cause of nasopharyngeal carcinoma is currently unknown, generally associated directly with EB virus infection. Secondly, their clinical manifestations are different. Patients with nasopharyngitis may experience dryness and pain in the nasopharyngeal area, and yellow secretions may occur when clearing the throat in the morning. In contrast, nasopharyngeal carcinoma typically presents as a painless mass. During examination with a nasopharyngoscope, the surface of nasopharyngitis is congested and swollen, whereas in nasopharyngeal carcinoma, cauliflower-like neoplasms or ulcers can be found at the top of the nasopharynx or near the pharyngeal recess. A local pathological examination can reveal symptoms and clarify the diagnosis. In terms of treatment, nasopharyngitis requires symptomatic anti-inflammatory treatment, while nasopharyngeal carcinoma requires local radiotherapy or chemotherapy.

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Written by Li Rui
Otolaryngology
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Does nasopharyngeal carcinoma require surgery?

Nasopharyngeal carcinoma generally does not consider surgery. For most patients with nasal cancer, radiotherapy is the first choice, and depending on the different stages, it may be necessary to consider concurrent or adjuvant chemotherapy. The overall treatment plan primarily focuses on curative radiotherapy, and it also requires regular follow-ups to monitor recovery. If radiotherapy and chemotherapy fail or there is a recurrence, surgery may need to be considered in these cases, but the surgery is relatively difficult, and a detailed analysis of the patient's specific situation is required. Only a very small number of patients would be indicated for surgery.

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Written by Li Rui
Otolaryngology
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How should nasopharyngeal carcinoma be examined?

Nasopharyngeal carcinoma is a relatively common otolaryngological disease and is also considered as one of the common head and neck malignant tumors. For diagnosis, an initial examination that can be conducted is nasopharyngoscopy. Through nasopharyngeal endoscopy, most patients can see changes in the nasopharynx due to new growths, which suggests considering a pathological biopsy test. This helps in obtaining a pathological diagnosis and allows for analysis and typing of the pathology. At the same time, imaging exams are necessary, with nasopharyngeal CT or MRI being commonly used. Additionally, it is recommended to test for the Epstein-Barr virus, as some patients’ condition could be a result of a long-term infection with this virus.

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Written by Deng Bang Yu
Otolaryngology
1min 4sec home-news-image

Distinction between Nasopharyngitis and Nasopharyngeal Carcinoma

Nasopharyngitis and nasopharyngeal carcinoma have fundamental differences. Nasopharyngitis is an inflammatory disease, while nasopharyngeal carcinoma is a malignant tumor disease. Clinically, nasopharyngitis mainly presents with increased secretions in the nasopharyngeal area, sometimes with a slight amount of bloody secretions, but this is extremely rare. On the other hand, nasopharyngeal carcinoma primarily shows symptoms such as the proliferation of malignant tumor tissues in the nasopharynx, enlargement of the lymph nodes in the neck, headaches, and ear stuffiness. In terms of treatment, nasopharyngitis is primarily treated with medications, such as traditional Chinese medicines, nasal sprays, and nasal corticosteroids; whereas nasopharyngeal carcinoma is primarily treated with radiotherapy combined with chemotherapy, which is currently the common sandwich therapy. Overall, there are fundamental differences between the two.