• Martina Marthatilova Department of Otorhinolaryngology-Head and Neck Surgery Medical Faculty Hasanuddin University, Makassar, Indonesia
  • Nani Iriani Djufri Department of Otorhinolaryngology-Head and Neck Surgery Medical Faculty Hasanuddin University, Makassar, Indonesia




Nasopharyngeal Carcinoma, Tuberculosis (TB), chemotherapy


Introduction :

Nasopharyngeal carcinoma is the most common head and neck malignancy in Indonesia. Diagnosis errors often occur in nasopharyngeal carcinoma due to non-specific symptoms such as symptoms of an infectious disease that resemble the symptoms of nasopharyngeal carcinoma.

Case Report :

In this case, it was explained how this diagnostic error occurred. A man, 39 years old with complaints of right and left neck lumps, the patient initially came to an ear nose throat (ENT) specialist and performed fine needle aspiration (FNA) and suggested a biopsy. But the patient did not continue his treatment at an ENT doctor. The patient continued his treatment at pulmonologist and was diagnosed with glandular Tuberculosis (TB) and received TB treatment. In the following 4th month on TB therapy, a lump in the right and left neck was felt getting bigger, then the pulmonary expert refers the patient to the oncology surgeon, the oncology surgeon department then refers to the ENT specialist because of the suspicion towards nasopharyngeal carcinoma. In the ENT department biopsy is performed on the nasopharynx and the result is bilateral nasopharyngeal Non-Keratinizing Cell Carcinoma, undifferentiated (WHO type III).


The patient was diagnosed with stage IV B nasopharyngeal carcinoma (T1N3M0). Currently, the patient has undergone chemotherapy with the paclitaxel and cisplatin regimen, and the 3rd cycle chemotherapy has been done.


[1] Sandhu KS, Chaudary P, Kumari A, Singh J. An unusual presentation of nasopharyngeal carcinoma. International Journal of Otorhinolaryngology Head Neck Surgery. 2017;3(4):1117.
[2] Tabuchi K, Nakayama M, Nishimura B, Hayashi K, Hara A. Early detection of nasopharyngeal carcinoma. International journal of otolaryngology. 2011;2011.
[3] Umar B, Ahmed R. Nasopharyngeal carcinoma, an analysis of histological subtypes and their association with EBV, a study of 100 cases of Pakistani population. Asian Journal of Medical Sciences. 2014;5(4):16-20.
[4] Chien Y-C, Chen J-Y, Liu M-Y, Yang H-I, Hsu M-M, Chen C-J, et al. Serologic markers of Epstein–Barr virus infection and nasopharyngeal carcinoma in Taiwanese men. New England Journal of Medicine. 2001;345(26):1877-82.
[5] Chang K-P, Hsu C-L, Chang Y-L, Tsang N-M, Chen C-K, Lee T-J, et al. Complementary serum test of antibodies to Epstein-Barr virus nuclear antigen-1 and early antigen: a possible alternative for primary screening of nasopharyngeal carcinoma. Oral oncology. 2008;44(8):784-92.
[6] Srivanitchapoom C, Sittitrai P. Nasopharyngeal tuberculosis: epidemiology, mechanism of infection, clinical manifestations, and management. International journal of otolaryngology. 2016;2016.
[7] Wu Z-X, Xiang L, Rong J-F, He H-L, Li D. Nasopharyngeal carcinoma with headaches as the main symptom: A potential diagnostic pitfall. Journal of cancer research therapeutics. 2016;12(1):209.
[8] Baddeley A, Dean A, Dias H, Falzon D, Floyd K, Baena I, et al. Global tuberculosis report 2013. World Health Organization. 2014:113-36.
[9] Menon K, Bem C, Gouldesbrough D, Strachan D. A clinical review of 128 cases of head and neck tuberculosis presenting over a 10-year period in Bradford, UK. The Journal of Laryngology Otology. 2007;121(4):362-8.
[10] Lee A, Ma B, Ng WT, Chan A. Management of nasopharyngeal carcinoma: current practice and future perspective. J Clin Oncol. 2015;33(29):3356-64.
[11] Ma BB, Hui EP, Chan AT. Systemic approach to improving treatment outcome in nasopharyngeal carcinoma: current and future directions. Cancer science. 2008;99(7):1311-8.
[12] Rottey S, Madani I, Deron P, Van Belle S. Modern treatment for nasopharyngeal carcinoma: current status and prospects. Current opinion in oncology. 2011;23(3):254-8.
[13] Yoshizaki T, Ito M, Murono S, Wakisaka N, Kondo S, Endo K. Current understanding and management of nasopharyngeal carcinoma. Auris Nasus Larynx. 2012;39(2):137-44.
[14] Soehartono RP, Kentjono W. Hubungan antara ekspresi latent membrane protein-1 dengan peningkatan ekspresi epidermal growth factor receptor pada karsinoma nasofaring jenis undifferentiated. ORLI. 2007;31(3):1-35.
[15] Edge SB, Compton CC. The American Joint Committee on Cancer: the 7th edition of the AJCC cancer staging manual and the future of TNM. Annals of surgical oncology. 2010;17(6):1471-4.



How to Cite

Marthatilova M, Djufri NI. MISDIAGNOSED OF NASOPHARYNGEAL CARCINOMA. IJNPC [Internet]. 2020Mar.18 [cited 2020May27];2(01):25-7. Available from: https://talenta.usu.ac.id/IJNPC/article/view/3667