Nasopharyngeal carcinoma with mesenchymal transition

Nasopharyngeal carcinoma is common nasopharyngeal malignancies accounting to 98%. The majority deaths of NPC patients are attributed to local recurrence and distant metastases. Most common variant is undifferentiated squamous cell carcinomas with a high tendency to invade adjacent tissues and metastasize to regional lymph nodes at an early stage. Tumors of the parapharyngeal space are uncommon, comprising less than 1% of all head and neck neoplasms and NPC might present rarely as parapharynegeal mass. Here is case of 38yr male with complaints of throat pain and swelling on left side for 1 month. CT scan suggested a prevertebral peripheral sheath tumor suggestive of schwanomma with lymphnode enlargement. On cytology high grade malignancy was considered and cellblock was prepared and IHC performed which confirmed Nasopharyngeal carcinoma (NPC) with epithelial mesenchymal transition. Diagnosis of NPC with EMT (especially nuclear vimentin and cytoplasmic E-cadherin) is important in the progression and clinical outcome as it has significant effects on the targeted therapy.