Benign symptoms of nasopharyngeal tumors

Swellings in the nose and eyes are commonly known as nasopharyngeal carcinoma, which is the most common nasal disease clinically. The swelling may become very large over time, and may even have local hyperplasia, affecting the normal development of the mucosa. It is very important to choose the corresponding treatment method based on your personal physical manifestations.

Does a tumor in the nasopharynx mean nasopharyngeal cancer?

Nasopharyngeal diseases are common in clinical practice, but their deep anatomical location causes the lesions to be hidden and the early symptoms to be unclear, making them very easy to misdiagnose in clinical work. Therefore, when a lump is found in the nasopharynx, in addition to considering nasopharyngeal carcinoma, the following lesions are possible and should be carefully differentiated.

(i) Adenoid hypertrophy: The adenoids are usually located in the front center of the vertex, forming a longitudinal ridge-like protrusion, and the surface is covered with smooth mucosa, the color is the same as normal mucosa. In childhood, the proliferation of lymphoid tissue on the top or posterior wall of the nasopharynx is more obvious. In severe cases, it affects nasal breathing and Eustachian tube obstruction, leading to hearing loss. Adenoids gradually atrophy in adulthood, but some people still have obvious residual adenoids, and a few may continue to retain them into middle age or even old age. The pathological manifestations are hyperplasia of lymphoid tissue in the interstitium, with common findings of increased number and size of lymphoid follicles, active germinal centers, and obvious phagocytosis. A few cases may show diffuse hyperplasia, adenoid hyperplasia, and hypersecretion. Capillary proliferation, endothelial cell proliferation, inflammatory cell infiltration in the vessel wall and surrounding areas. There is also reticular cell hyperplasia in the deep lymphocytes. In addition to occurring on the anterior wall of the nasopharyngeal roof, lymphoid tissue can also be seen in the posterior and superior areas of the Eustachian tube carina and above the descending process. In clinical practice, nasopharyngeal carcinoma often occurs in the gaps between the adenoids. If only the strip-shaped adenoids are biopsied, the pathology report will often show lymphatic hyperplasia. The biopsy should be performed by biting off a small amount of tumor granulation tissue deep in the adenoids to improve the detection rate of nasopharyngeal carcinoma.

(ii) Nasopharyngitis: Nasopharyngitis is a common upper respiratory tract infection. The nasopharynx is located at the junction of the nose and pharynx. Nasal secretions mostly flow down from the nasopharynx and are spit out through the mouth, which also increases the chance of nasopharyngeal infection. The clinical manifestations of nasopharyngeal inflammation are mostly nasopharyngeal discomfort. Increased nasopharyngeal secretions are manifested as nasopharyngeal drip, or a foreign body sensation in the throat, nasopharyngeal pain, etc. Clinical examinations show congestion of the nasopharyngeal mucosa and increased secretions. The final diagnosis must rely on pathological examination.

(III) Nasopharyngeal tuberculosis: It may form superficial ulcers or granulation-like protrusions in the nasopharynx, and may even affect the entire nasopharyngeal cavity. If the patient also has tuberculosis of the cervical lymph nodes, it is quite similar to nasopharyngeal carcinoma and a biopsy is required to make a diagnosis, with special attention paid to whether cancer and tuberculosis coexist. Nasopharyngeal tuberculosis rarely occurs alone, and patients may also suffer from pulmonary tuberculosis. Examination of serum tuberculosis antibodies and bacteriological examination of secretions for Mycobacterium tuberculosis can help with diagnosis.

(IV) Nasopharyngeal angiofibroma: Some people call it "male adolescent hemorrhagic nasopharyngeal angiofibroma", and this tumor name summarizes the clinical and pathological characteristics. The tumor arises from the nasopharyngeal skull base, sphenoid bone and occipital periosteum or skull base aponeurosis. The giant body is irregularly lobed, round or oval in shape, without a complete capsule, and has a tough texture. The disease is composed of two components: fibrous tissue and blood vessels. This tumor rarely becomes malignant. Patients with nasopharyngeal angiofibroma are mainly young men, most commonly between 10 and 25 years old. The clinical manifestations are repeated massive nosebleeds, sometimes up to 1000ml at a time, accompanied by nasal congestion, hearing loss, headache, etc. The tumor originates in the nasopharynx and can spread to surrounding organs. It invades the nasal cavity and even the anterior nares, and then moves forward and outward through the pterygopalatine fossa and maxillary sinus to the infratemporal fossa. It can also invade the face, invading the orbit, sphenoid sinus, skull base and intracranial space. Clinical examination shows that nasopharyngeal tumors are red or light red, with a smooth surface covered by mucosa, visible blood vessels, and generally no necrosis or ulcers on the outside of the tumor. This tumor can cause massive bleeding during biopsy, and even be life-threatening, so biopsy should be avoided. Plain scan CT examination shows soft tissue masses in the nasopharynx or posterior nasal cavity with equal density and unclear boundaries. After enhancement, the lesions are significantly enhanced, which is related to the rich blood vessels.