The diagnosis based on the clinical history is most likely a case of Nasopharyngeal carcinoma

The diagnosis based on the clinical history is most likely a case of Nasopharyngeal carcinoma.

✨ History of China is also important (endemic in that region).

✨ Usually arises from fossa of rosenmuller in nasopharyngeal wall.

✨ First presentation is by painless cervical lymphadenopathy.

✨ Other clinical manifestations:

  • Unilateral nasal discharge, nosebleeds, impaired nasal breathing (due to obstruction)

  • Obstruction of the Eustachian tube: recurrent otitis media (may be accompanied by effusion); conductive hearing loss, tinnitus

  • Infiltration of caudal cranial nerves → Garcin syndrome

  • Sore throat

  • Headache.

✨ Associated with EBV infection.

✨ Positive staining for cytokeratin assures it’s epithelial origin and LCA negativity rules out possibilities of lymphoma.