[Recognition of nasopharyngeal carcinoma]

In two patients the presenting symptoms of nasopharyngeal carcinoma were non-specific: a woman aged 35 years born in Hong-Kong with unilateral hearing loss, and a man aged 59 years with acute otitis media who later developed cranial nerve palsy. The woman was successfully treated with chemotherapy and radiotherapy, the man was in a poor general condition and refused treatment; he died within 9 weeks. Nasopharyngeal carcinoma is rare and can occur at any age. Symptoms of the disease are not specific and sometimes subtle resulting in a late diagnosis and a reduced chance of cure. In South-East Asia its incidence is much higher and recognition and prognosis are better. If a malignant tumour in the nasopharynx is suspected, endoscopy may not be adequate as the tumour can grow submucosally, necessitating radiological examination with MRI or CT. MRI is the most sensitive radiological examination for the detection of this tumour and the assessment of the extent of its local and perineural spread.