ArticleJournal of medical case reports2026
Nasopharyngeal carcinoma masquerading as a primary sinonasal mass: a case report.
Article in Journal of medical case reports, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundNasopharyngeal carcinoma (NPC) typically arises from the nasopharyngeal vault and most commonly presents with cervical lymphadenopathy or otologic symptoms. Presentation with a dominant anterior sinonasal mass is exceptionally uncommon and may obscure the true site of origin, leading to diagnostic misclassification as a primary sinonasal malignancy. Cross-sectional imaging, such as computed tomography (CT), may be inconclusive in such cases, necessitating a multimodal approach for accurate diagnosis. CASE PRESENTATION: A 54-year-old Indian male presented with progressive unilateral nasal obstruction, recurrent epistaxis, facial swelling, visual impairment, and bilateral hearing loss. Nasal endoscopy revealed a bulky anterior sinonasal mass obstructing visualization of the nasopharynx. CT imaging showed a destructive mass involving the nasal cavity and paranasal sinuses with posterior extension toward the nasopharynx though the primary site remained uncertain. Incisional biopsy revealed a poorly differentiated non-keratinizing carcinoma. Immunohistochemistry (IHC) for p40/p63 and Epstein-Barr virus (EBV)-encoded RNA in situ hybridization confirmed nasopharyngeal carcinoma. Whole-body
conclusionThis case highlights a diagnostic pitfall in which nasopharyngeal carcinoma presents as a predominant anterior sinonasal mass, closely mimicking a primary sinonasal malignancy. Reliance on cross-sectional imaging alone may delay diagnosis. Early biopsy, EBV testing, and multimodal evaluation including PET-CT are essential for accurate tumor localization and staging. Awareness of this atypical presentation may help clinicians avoid diagnostic delay and optimize patient care.
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