A 50-year-old Chinese male presents with a neck mass, unilateral serous otitis media, and nasal obstruction. Nasopharyngoscopy shows a suspicious submucosal mass in the fossa of Rosenmuller. Biopsy shows undifferentiated carcinoma. Which virus is associated with this tumor, and what serological marker supports the diagnosis?

• A HPV type 16; p16 immunohistochemistry positivity
• B Cytomegalovirus; CMV IgM titers
• C Human herpesvirus 8 (HHV-8); LANA-1 staining
• D Epstein-Barr virus (EBV); elevated serum VCA IgA and EA IgA antibody titers ✓

Explanation

Nasopharyngeal carcinoma (NPC) is strongly associated with Epstein-Barr virus (EBV), particularly the non-keratinizing undifferentiated subtype (WHO type III). Elevated serum anti-VCA (viral capsid antigen) IgA and anti-EA (early antigen) IgA titers are diagnostic markers and are used for population screening in endemic regions (South China, Southeast Asia). Plasma EBV DNA levels also correlate with disease activity and treatment response. HPV is associated with oropharyngeal (not nasopharyngeal) carcinoma.

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.