First report of opportunistic screening for nasopharyngeal carcinoma by gastroscopy

A 45-year-old woman presented at our hospital with epigastric pain. Gastroscopy was undertaken, but before the gastroscope was inserted into her esophagus, her nasopharynx was examined. This examination revealed a 1.8-cm lesion ([Video 1]) near the pharyngeal opening of the eustachian (pharyngotympanic) tube on the right side. Blue light imaging and linked color imaging showed irregular microvasculature on the surface of the lesion ([Fig. 1]). Pathological analysis identified squamous cell nonkeratinized carcinoma, with positive immunohistochemistry for P40 ([Fig. 2] a) and CK5/6 ([Fig. 2] b). The Ki-67 index was 50%. Subsequently, the patient was diagnosed with nasopharyngeal carcinoma. This is the first report of opportunistic screening for nasopharyngeal carcinoma using gastroscopy.