A 45-year-old Chinese male presents with a painless unilateral cervical lymphadenopathy at level II for 6 weeks. He also has unilateral nasal obstruction and bloody nasal discharge. Nasopharyngoscopy reveals a mass in the right fossa of Rosenmuller. Biopsy confirms undifferentiated nasopharyngeal carcinoma. EBV LMP-1 is positive. According to AJCC 8th edition, a T2 NPC involves:

• A Confined to the nasopharynx only
• B Skull base erosion
• C Intracranial extension or cranial nerve involvement
• D Extension to parapharyngeal space and/or adjacent soft tissue ✓

Explanation

In AJCC 8th edition NPC staging: T1 = limited to nasopharynx (or extension to oropharynx/nasal cavity). T2 = extension to parapharyngeal space and/or adjacent soft tissue (medial pterygoid, lateral pterygoid, prevertebral muscles). T3 = skull base erosion, cervical vertebra, pterygoid structures, or paranasal sinuses. T4 = intracranial extension, cranial nerve involvement, orbit, hypopharynx, or masticator space beyond lateral pterygoid. Distinction from T1 to T2 is prognostically important.

Reference: Dhingra Diseases of Ear, Nose and Throat, 7th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.