What are the symptoms and ways of nasopharyngeal carcinoma spread and metastasis?

What are the symptoms of nasopharyngeal carcinoma metastasis? What are the ways?

In the late stage of nasopharyngeal carcinoma, eye symptoms: If the tumor invades the orbit or eye-related nerves, patients with late-stage nasopharyngeal carcinoma may experience visual impairment or even blindness, visual field defects, diplopia, proptosis and limited movement of the eyeball, neuroparalytic keratitis, etc.

Optic nerve atrophy and edema can be seen in fundus examination. These manifestations are mostly late-stage symptoms of nasopharyngeal carcinoma, but some patients with late-stage nasopharyngeal carcinoma still seek medical treatment for these symptoms.

There are generally three ways for nasopharyngeal carcinoma to metastasize:

1. Direct spread

Nasopharyngeal carcinoma can extend upward and invade and destroy the skull base bones, with the oval foramen being the most common site. In the late stage, it can destroy the sella turcica and invade the II to VI cranial nerves through the ruptured foramen, causing corresponding symptoms. Nasopharyngeal carcinoma can invade the oropharynx, palatine tonsils, and tongue root downward, the nasal cavity and orbit forward, the cervical spine backward, and the Eustachian tube to the middle ear laterally.

2. Lymphatic metastasis

The nasopharyngeal mucosal lamina propria is rich in lymphatic vessels, so nasopharyngeal carcinoma can metastasize to the lymph nodes. About half of nasopharyngeal carcinoma patients come to the hospital because of swollen cervical lymph nodes. It first metastasizes to the posterior pharyngeal wall lymph nodes, then to the deep neck and other cervical lymph nodes, and rarely to the superficial cervical lymph nodes. Cervical lymph node metastasis is usually on the same side, followed by bilateral, and rarely to the opposite side.

3. Hematogenous metastasis

In the late stage, nasopharyngeal carcinoma often metastasizes to the liver, lungs, bones, followed by the kidneys, adrenal glands, and pancreas. When these organs are uncomfortable, the possibility of cancer metastasis needs to be considered.