How nasopharyngeal carcinoma spreads

The nasopharynx is hidden, and nasopharyngeal carcinoma is very prone to early metastasis. Therefore, when the primary cancer is very small or not obvious, it has already metastasized to the cervical lymph nodes and cranial nerves. Due to the location of the onset, the spread of nasopharyngeal carcinoma also has its own characteristics.

Direct spread

The most prominent feature of the spread of nasopharyngeal carcinoma is its deep infiltration. It can go upward through the foramen ovale to destroy the skull base and even the sella turcica, invading the pituitary gland and causing a series of endocrine disorder symptoms. It can also invade the tissues near the cavernous sinus through the foramen rupture, causing damage to the II to VII cranial nerves, causing symptoms such as migraine, diplopia, and strabismus. It can go outward to invade the Eustachian tube to the middle ear, causing hearing impairment. It can extend downward to invade the soft palate and epiglottis, causing hoarseness and dysphagia. It can go forward to invade the nasal cavity, causing nasal congestion, bloody mucus and other symptoms. It can go backward to invade the cervical spine and cervical spinal cord.

Lymphatic metastasis

The nasopharyngeal mucosal lamina propria is rich in lymphatic vessels, so the cancer often metastasizes to the lymph nodes in the early stages. Generally, it first metastasizes to the retropharyngeal lymph nodes, and then to the deep cervical lymph nodes. It is usually ipsilateral metastasis, but it can also be bilateral. Then it spreads along the sternocleidomastoid and downward to the mediastinal lymph nodes. The lymph nodes adhere to each other, forming a large and hard mass in the neck. At the same time, it compresses the cranial nerves and cervical sympathetic nerves, causing corresponding symptoms.

Hematogenous metastasis

Hematogenous metastasis of nasopharyngeal carcinoma is relatively rare, and metastasis to the liver, lungs, and bones usually occurs in the late stage. It is less common in the adrenal glands, pancreas, etc.