Nature History, Presenting Symptoms, and Diagnosis of Nasopharyngeal Carcinoma

Nasopharyngeal carcinoma (NPC) is an epithelial carcinoma arising from the nasopharyngeal mucosal lining. In the nasopharynx, the tumor is often observed at the pharyngeal recess. Effective population screening and early diagnosis could improve treatment outcomes by identifying early-stage disease in patients with nasopharyngeal carcinoma. Unfortunately, the clinical manifestation can often be very deceptive and confusing until the disease progresses into a relatively advanced stage (Bedwinek et al. 1980). Coupled with the difficulty associated with thorough examination of the nasopharynx, this disease presents a diagnostic challenge to physicians. Only about 10% of all new patients present with early disease despite recent advances in diagnostic techniques such as fiber-optic examination, diagnostic imaging, and tumor serology. The presenting symptoms are closely related to the location of the tumor in nasopharynx, the extent of local tumor invasion, and the degree of regional nodal metastasis. Because early symptoms are frequently minimal in nature, they are easily ignored by the physician and the patient. A high index of suspicion is crucial in a timely diagnosis of nasopharyngeal carcinoma, especially in endemic areas like Southeast Asia and areas with a large number of Chinese immigrants. As mentioned earlier, the treatment outcomes of NPC depend on the stage of the disease, and delaying the diagnosis of NPC can potentially be detrimental.