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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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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Can nasopharyngeal carcinoma be treated?

Nasopharyngeal carcinoma is a common clinical disease, especially in the southern regions of China. It primarily affects the nasal area as a malignant tumor. The clinical treatment outcomes for nasopharyngeal carcinoma are relatively good, and it is also referred to as "fortunate cancer," which implies that it has a relatively high cure rate. The main clinical treatment involves radiation therapy combined with chemotherapy, often described as the "sandwich" treatment method. Any tumor can be cured if detected early, and the early detection rate of nasopharyngeal carcinoma is relatively high. Therefore, its cure rate is also relatively high compared to other major organ tumors such as liver and lung cancers, which exhibit relatively lower cure rates and outcomes.

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What is nasopharyngeal carcinoma?

Nasopharyngeal carcinoma is a relatively common malignant tumor in the nasopharyngeal area, and the main pathological type is predominantly squamous carcinoma, most of which are poorly differentiated squamous carcinomas, constituting the most common malignant tumor in the nasopharyngeal area. Currently, the primary treatment option is radiotherapy, which is the most important; some patients may need to consider concurrent or adjuvant chemotherapy. If drug and radiotherapy treatments are ineffective, or if there is cervical lymph node metastasis, and for some patients where chemoradiotherapy fails with residual lesions, surgery may be considered. However, currently, the surgical treatment approach is generally not very mature and is somewhat controversial, thus it requires treatment at major hospitals.

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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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Does nasopharyngeal carcinoma cause coughing?

Nasopharyngeal carcinoma is a relatively common type of malignancy in the head and neck area, and a small number of patients may experience coughing, mainly because the secretions from the nasopharyngeal carcinoma can enter the throat through the posterior nasal aperture, causing an irritative cough. Overall, the occurrence of this symptom is relatively rare. More common symptoms include nasal congestion, bloody nasal discharge, with some patients experiencing headaches or enlarged cervical lymph nodes, and changes in vision. After diagnosis, it is recommended to visit the otolaryngology or oncology departments promptly to assess the severity of the condition. Most patients need to consider radiotherapy and chemotherapy, and regular follow-ups are necessary to monitor treatment outcomes.