A 35-year-old man presents with a left-sided cervical mass. Fine needle aspiration cytology shows metastatic squamous cell carcinoma. Examination of the nasopharynx reveals a submucosal mass. Which investigation is most useful for confirming the primary site?
- A CT scan of the neck
- B Nasopharyngeal biopsy under anesthesia ✓
- C EBV DNA testing
- D PET-CT scan
Correct answer: B. Nasopharyngeal biopsy under anesthesia
Explanation
Nasopharyngeal biopsy under anesthesia is the gold standard for confirming the diagnosis of nasopharyngeal carcinoma when a submucosal mass is detected. CT scan shows the extent of the lesion but cannot confirm the diagnosis. EBV DNA testing supports the diagnosis but is not confirmatory. PET-CT is useful for staging but not for primary diagnosis. Histopathological confirmation is mandatory before treatment.
Reference: Diseases of Ear, Nose and Throat, 7th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.