Nasopharyngeal carcinoma

Chief Complaint A 64 y/o male presents with the complaint of headache and hearing loss for 5 months. History Patient is diabetic and hypertensive. No past surgical history. Vitals BP: 125/80 mmhg, Pulse: 74 beets/minute, Respiratory rate: 18 bpm. Examination Examination shows an enlarged right cervical lymph node of 1.5×3 cm was also noted. Investigations CT scan shows a nasopharyngeal mass extending to the right parapharyngeal space. Pathology shows Nasopharyngeal carcinoma. Treatment Need your valuable opinion on the management plan.


A concomitant chemoradiotherapy is indicated in this case . A regular follow up is indicated . Particularly-,if right cervical lymph nodes do not regress- surgery for lymph nodes may be indicated

Chemoradiotherapy can be initiated. Rt cervical lymph node after assessment and evaluation surgical intervention required followed by chemoradiotherapy. Prognosis explained. Regular monitoring and constant evaluation to avoid further complications. Multivitamin and antioxidant orally.

Thanks Dr Shivraj Agarwal

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What is stage of malignancy Biomarkers to decide Yes initially chemoradiotherapy can be initiated Early stage surgery will be preferable Followed by chemoradiotherapy Adv for pet scan

Thanx dr Ashok Leel

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PET CT scan to rule out distant metastasis. If it is locoregional disease Induction chemotherapy followed by definative concurrent chemo radiotherapy

Endoscopic resection of tumour Histopathological examination Chaemoradiation If cervical lymphadenopathy persists MRND

pet ct for detection of staging and metastais -to plan for chemo/radio

Refer to medical oncologist. Pt needs whole body PET CT scan to assess for metastatic disease for staging He will need CTRT or Chemotherapy based on the stage of the disease

Needs oncologist opinion

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