NASOPHARYNGEAL CARCINOMA
OTORHINOLARYNGOLOGY, HEAD & NECK SURGERY SERVICES
MINISTRY OF HEALTH MALAYSIA
Brain:
n Chronic Headache. n Facial paralysis, week eye movement
(opthalmoplegia) or Stroke. n Confuse n Convulsion n Coma
Others: n Spread to bone causing brittle bone and
easily fracture esp. vertebra and pelvis. n Spread to the lungs cause bloody cough and
chest pain. n Spread to the lymph node causing swelling
of lymphatic systems. Investigations:
n Nasoendoscopy and biopsy. n Fine Needle Aspiration and Cytology: taken
sample from the swelling for cytology. n CTScan : to look for extension of the tumour
and staging. n MRI : soft tissue assessment.
Treatment:
¨ Stage I-II: Radiotherapy ¨ Stage III-IV: Concurrent
Chemoradiotherapy ¨ Local recurrence: Brachytherapy /
chemotherapy ¨ Regional recurrence: Surgery to
remove lymphatic chain from the neck
¨ Loco-regional: Surgery / CCRT?
CO N T ACT TH E N EA REA ST CL I N IC /H O SP I TAL
Nasopharynx carcinoma
Epidemiology • NPC is the fourth most common cancer
among Malaysian, and the third most common cancer among males • Most common age at the presentation is
between 40-60 years old • It is predominantly among Chinese (49%)
followed by native of Sabah & Serawak Risk factor Combination from below factor: 1. Life style and environment • Tobacco smoking • Consumption of salted fish • Exposure to occupational solvent and wood
dust 2. Infection • Increased risk of NPC in those tested
positive for Epstein Barr virus infection 3. Family Genetic / Hereditary • Increased risk in those with family history
of cancer
Symptoms: Nose: ■ Blood stained nasal discharge or saliva ■ Nasal blockage ■ Bad breath
Ear: ■ Ear block ■ Buzzing sound in the ear (Tinnitus) ■ Decrease of hearing ■ Ear pain
Neck: ■ Painless neck swelling unilateral or
bilateral Opthalmo-neurologic symptom: ■ Unilateral headache ■ Facial numbness ■ Diplopia ■ Ptosis ■ Trismus ■ dysphagia ■ Hoarseness
What is Nasopharyngeal carcinoma? • Nasopharyngeal Carcinoma (NPC) is a
cancer that arising from back of the nose • It start from fossa of ressenmuller • It can spread locally, laterally to Eustachian
tube, superiorly to the brain, nasal cavity anteriorly, pharynx inferiorly. It also can spread to the lymphatic system, lung, bone and liver.
Normal nasopharynx