Nasopharyngeal carcinoma with skull base erosion cytologic findings

Nasopharyngeal carcinoma (NPC) occurs more frequently in patients with south-east Asian racial backgrounds. This disease may spreads superiorly to the skull base and intracranium followed by skull base destruction. We report a 56 year-old man presented with headache and diplopia. Magnetic resonance imaging (MRI) revealed extension of destructive mass from ethmoid sinus to the parenchyma. Intraoperative touch cytology showed loose syncytial sheets of pleomorphic abnormal epithelial cells, dyskeratotic cells with abnormal chromatin clumping and irregular nuclear outlines, in a necrotic background. These findings were infavor of keratizing squamous cell carcinoma which was confirmed by histopathology. During interpretation of intraoperative imprint cytology of central nervous system tumors, the possibility of local invasive tumors like NPC should be considered.