A person with neck nude and B type tympanogram
Information in this question:
 
Cervical adenopathy (Seek node)Most common presentation of nasopharyngeal carcinoma,
 
Type B tympanogram:- Indicates serous otitis media, which may be a complication of nasopharyngeal carcinoma due to eustachian tube blockade,
 
o Thus, among the given options, nasopharyngeal carcinoma is the answer of choice.
 
Clinical features of nasopharyngeal carcinoma
 
o Symptomatology of nasopharyngeal carcinoma is divided into five main groups:-
 
1) Nasal symptoms
 
o Nasal obstruction, nasal discharge, denasal speech (rhinolalia clausa), epistaxis.
 
2) Otologic symptoms
 
Otologic symptoms are due to obstruction of eustachian tube.
 
o This results in serous or suppurative otitis media. Which causes conductive deafness.
 
Presence of unilateral serous otitis media in adult should raise the suspicion of nasopharyngeal carcinoma a Tinnitus and dizziness may occur.
 
3) Ophthalomoneurological symptoms
 
o These symptoms occur due to spread of tumor to the surrounding regions.
 
Squint and diplopia due to involvement of VIth cranial nerve.
 
Ophthalmoplagia due to involvement of IVrd, IVth& Vim cranial nerve.
 
Facial pain X reduced corneal sensations due to Vth nerve involvement a Exophthalmos and blindness due to direct extension into the orbit.
 
Jugular foramen syndrome (IXth, Xth, XIth cranial nerve involvement) due to pressure by enlarged lateral retropharyngeal lymph nodes.
 
Cranial nerve XIIth involvement due to extension of growth to hypoglossal canal.
 
Horner’s syndrome due involvement of cervical sympathetic chain.
 
Neck mass:- It is the most common presentation (60-90%)
 
o  Due to cervical lymphadenopathy.
 
Distant metastasis
o Involve bone, lung, liver and other sites.
Acoustic neuroma
Nasopharyngeal CA
Angiofibroma
None