Woman’s chronic nasal symptoms reveal rare, aggressive nasopharyngeal cancer after three years
Doctors say extensive tumor reached the brainstem and cerebellum; radiation alone led to full remission in the 37-year-old patient
A 37-year-old woman in China was diagnosed with an advanced and unusually aggressive form of nasopharyngeal carcinoma after living for years with symptoms she and doctors initially attributed to allergies and the common cold.
The patient reported three years of nasal congestion, double vision and difficulty processing sounds and language, and nearly a year of headaches and numbness on the left side of her face. When she finally sought care at a local hospital, clinicians found speech difficulties, hearing loss in both ears, facial numbness, recurring nosebleeds and impaired mobility that required use of a wheelchair. Magnetic resonance imaging showed an extensive tumor in the nasopharynx that extended into the brainstem, cerebellum, base of the skull and the upper spine. Treating physicians published the case in a medical journal and diagnosed stage four nasopharyngeal carcinoma.
Physicians who reported the case said the diagnosis had been delayed after the woman was repeatedly misdiagnosed at multiple hospitals, including a specialized neurosurgical center. "She was repeatedly diagnosed with difficulty as having meningioma or a pituitary tumor in many large hospitals," the authors wrote. They added that reliance on previous, inaccurate assessments led to delayed definitive management and that the patient subsequently received supportive herbal therapy while her condition worsened.
The case was described as "exceptionally rare" because the tumor had invaded the brainstem, an extension seen in less than 1 percent of nasopharyngeal carcinoma cases, the authors said. Despite the advanced staging, the patient declined recommended surgical intervention because of concerns about risks and quality of life. She instead underwent multiple rounds of radiation and, according to the treating doctors, achieved a full remission.
Nasopharyngeal carcinoma originates in the nasopharynx, the upper part of the throat that connects the nasal cavities to the rest of the respiratory tract. It is uncommon in the United States and other Western countries; estimates cited by the treating team describe incidence on the order of a few thousand cases annually in the U.S. and roughly one case per 100,000 people per year in some populations. Nationwide data indicate oral cavity and pharynx cancers, a broader category that includes nasopharyngeal carcinoma, account for tens of thousands of diagnoses and thousands of deaths each year in the U.S.
The Epstein-Barr virus (EBV) has been linked to many cases of nasopharyngeal carcinoma; EBV is highly prevalent worldwide and commonly causes mild, cold-like illness. Dietary and environmental factors have also been implicated; chemicals released from steam during preparation of salt-cured foods have been proposed as a possible risk factor because they may damage DNA in nasal passages. Epidemiological studies have reported higher rates of nasopharyngeal carcinoma among people of Chinese descent, with some analyses finding markedly higher incidence in Chinese Americans compared with white Americans.
Typical presenting symptoms include a lump in the neck from a swollen lymph node, nosebleeds, bloody saliva, double vision, recurring ear infections, facial numbness, headaches, hearing loss, nasal stuffiness, tinnitus and sore throat. The treating doctors noted that two-thirds of nasopharyngeal carcinoma cases are diagnosed at late stages, often after initial misdiagnoses, which contributes to worse outcomes. Five-year survival for early-stage disease can exceed 80 percent, while it falls substantially once the disease has spread to distant areas.
The authors of the case report emphasized the diagnostic value of imaging both the nasopharyngeal region and the brain when symptoms involve cranial nerves, vision changes or hearing loss. They wrote that combined scans are "crucial for detecting this rare form of cancer," particularly when clinical findings suggest involvement beyond the nasopharynx.
The physicians described the patient's clinical course and treatment choices without speculating on the underlying cause in her individual case. Their report underscores the difficulty of diagnosing rare head and neck cancers when symptoms mimic common conditions, and it highlights the role of thorough imaging and multidisciplinary evaluation in preventing delayed diagnosis and enabling timely treatment.