Diagnosis and Staging of Nasopharyngeal Cancer

Abstract

Nasopharyngeal carcinoma (NPC) typically arises from the fossa of Rosenmüller with a tendency to invade adjacent structures. Nodal involvement is common while distant metastasis is relatively rare at initial presentation. Painless neck lumps, nasal and aural symptoms are frequently the first complaints whereas cranial nerve palsies may signify locally advanced disease. Nasoendoscopy and biopsy should be performed for diagnosis. Magnetic resonance imaging (MRI) is the modality of choice for assessment of the local regional disease extent. Positron emission tomography integrated with computed tomography (PET/CT) is useful for the detection of distant metastases and may increase the accuracy of the assessment of cervical nodal metastases. Epstein-Barr virus deoxyribonucleic acid (EBV DNA) has been shown to carry prognostic value and may enhance risk categorization. The American Joint Committee on Cancer and Union for International Cancer Control (AJCC/UICC) cancer TNM staging system should be used for staging of NPC.