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Published: 2025-08-29
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DOI: https://doi.org/10.52852/tcncyh.v193i8.3815
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Vol. 193 No. 8 (2025)
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Đào, P. T. B. ., Đào, N. T. A. ., My, N. D. ., Hoàng Anh, N. C. ., Phúc, T. N. T. ., Trần Anh, P. ., Thủy, P. T. B. ., & Thắng, T. X. . (2025). Nasopharyngeal carcinoma detected by MRI following persistent otitis media of unclear etiology: A case report. Journal of Medical Research, 193(8), 619-627. https://doi.org/10.52852/tcncyh.v193i8.3815

Nasopharyngeal carcinoma detected by MRI following persistent otitis media of unclear etiology: A case report

Pham Thi Bich Dao, Nguyen Thi Anh Dao, Nguyen Dieu My, Nguyen Cong Hoang Anh, Tran Ngoc Tam Phuc, Pham Tran Anh, Pham Thi Bich Thuy, Tong Xuan Thang

Main Article Content

Abstract

We present a case of advanced-stage nasopharyngeal carcinoma (NPC) in a 51-year-old male, whose initial and sole symptom was persistent right-sided tinnitus lasting over one year. The patient had undergone multiple courses of empirical treatment for serous otitis media without improvement. Repeated nasoendoscopic evaluations revealed no detectable abnormalities. Magnetic resonance imaging (MRI) of the head and neck subsequently identified a large nasopharyngeal mass (30 × 60 mm) on the right side, with skull base invasion and parapharyngeal extension, accompanied by bilateral cervical lymphadenopathy. Fine-needle aspiration of a right cervical lymph node confirmed non-keratinizing squamous cell carcinoma, leading to a definitive diagnosis of stage T4N2M0 NPC. The patient was treated with a Gemcitabine–Cisplatin chemotherapy regimen and achieved an initial partial response. However, local recurrence at the primary site was detected on follow-up MRI after 10 months. This report highlights the role of MRI and cervical lymph node biopsy in diagnosing atypical nasopharyngeal carcinoma, particularly in cases with negative nasoendoscopic findings but persistent serous otitis media.

Article Details

Keywords

nasopharyngeal carcinoma, otitis media with effusion, negative nasoendoscopy, nasopharyngeal MRI, cervical lymph node metastasis

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