Nasopharyngeal tumor initially manifested as myofascial pain dysfunction syndrome

A patient with facial pain of 1 1/2 years' duration, associated with limitation of opening of the mouth, click, and osteodegenerative changes of the temporomandibular joint, was initially thought to be suffering from a myofascial pain dysfunction syndrome. At first, the patient reacted favorably to muscle exercises and an antidepressive drug, but reduced lacrimation and the development of deafness on the affected side led to re-evaluation and a diagnosis of nasopharyngeal tumor. Biopsy confirmed the presence of an adenocarcinoma of the nasopharynx. The variability of symptoms and the diagnostic problems presented by this tumor are discussed.