Advanced Nasopharyngeal Carcinoma without Cervical Lymphnodes

Nasopharyngeal carcinoma (NPC) is the most frequent malignancy arising in the nasopharynx. While cervical lymph node metastases are common at diagnosis, rare cases may occur without nodal involvement. We report the case of a 48-year-old man presenting with headache, epistaxis, and nocturnal snoring. Clinical examination revealed no palpable cervical lymphadenopathy. Imaging showed nasopharyngeal thickening with lysis of the sphenoidal floor and intracranial extension. Histological evaluation confirmed a high-grade undifferentiated infiltrating carcinoma of type UCNT. The patient responded well to chemotherapy.