Nasopharyngeal carcinoma is an aggressive tumor with a propensity for skullbase invasion. Although rare in North America, its dramatically increased incidence in China remains an epidemiologic curiosity. The incidence peak of nasopharyngeal carcinomas approaches 50 yr of age, with males being most commonly affected. Most nasopharyngeal carcinomas arise in the superior aspect of the nasopharynx and promptly invade the skull base, often extending intracranially through bony foramina. Secondary involvement of the sphenoid sinus occurs commonly, with occasional extension into the sella, cavernous sinus, and parasellar region. The clinical presentation is usually one of pain, epistaxis, nasal obstruction, and eventual cranial neuropathies (especially the trigeminal nerve). Radiation therapy is the primary mode of treatment, surgery being reserved for recurrent tumors, often in the context of salvage surgery. Depending on the radiosensitivity and degree of differentiation, 10-yr survival rates are approx 30% (121).
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