A 50-year-old male Chinese patient presents with a neck mass at level II and epistaxis. Flexible nasopharyngoscopy reveals a mass in the fossa of Rosenmuller. Biopsy shows non-keratinizing undifferentiated carcinoma. The etiological virus and most commonly used radiological staging investigation are respectively:
- A HPV; CT PNS with contrast
- B EBV; PET-CT alone
- C EBV; MRI nasopharynx and skull base with gadolinium ✓
- D HSV-2; MRI
Explanation
Nasopharyngeal carcinoma (NPC), particularly the undifferentiated (WHO type III) and non-keratinizing (WHO type II) subtypes, is strongly associated with Epstein-Barr virus (EBV) infection, especially in endemic regions (Southeast Asia, Southern China). Plasma EBV DNA levels (viral load) serve as both a diagnostic and prognostic biomarker. MRI of the nasopharynx and skull base with gadolinium is the preferred staging investigation because it provides superior soft tissue contrast and delineates skull base involvement, intracranial extension, and perineural spread better than CT.
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.