A 55-year-old man from Southeast Asia presents with unilateral serous otitis media, epistaxis, and right lateral rectus palsy. Contrast-enhanced MRI of the head shows a mass in the nasopharynx extending through the foramen lacerum into the cavernous sinus. The most likely diagnosis is:
- A Nasopharyngeal angiofibroma
- B Nasopharyngeal carcinoma ✓
- C Lymphoma
- D Rhabdomyosarcoma
Correct answer: B. Nasopharyngeal carcinoma
Explanation
Nasopharyngeal carcinoma is endemic in Southeast Asian populations and classically presents with unilateral serous otitis media (due to Eustachian tube obstruction), epistaxis, and cranial nerve palsies. Extension through foramen lacerum into the cavernous sinus causing CN VI palsy is characteristic. Angiofibroma occurs in adolescent males and does not invade the cavernous sinus. Rhabdomyosarcoma is a pediatric tumor.
Reference: Head and Neck Imaging, 5th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.