There are three ways for nasopharyngeal carcinoma cells to metastasize

When nasopharyngeal carcinoma develops to the late stage, cancer cell metastasis may occur, and the main pathways are as follows.

Direct spread: The tumor 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 foramen rupture, causing corresponding symptoms. The tumor 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.

Lymph node metastasis: Cervical lymph nodes account for about 1/3 of the total lymph nodes in the body, especially deep lymph nodes, which are closely related to tumor metastasis. Nasopharyngeal carcinoma is characterized by early metastasis of cervical lymph nodes and a high metastasis rate. Metastatic lymph nodes are often multiple, hard masses of varying sizes. Generally, they grow from small to large as the disease progresses, and their number increases. They gradually merge into a huge mass, and their mobility is gradually limited. Usually, the metastasis is from the upper neck to the lower neck. About half of the patients have bilateral neck metastasis, and preauricular lymph node metastasis is less common.

Distant metastasis: The rate of distant metastasis of nasopharyngeal carcinoma is relatively high, which is obviously related to whether the primary tumor invades outside the nasopharynx, whether the cervical lymph nodes have metastasized, and the size and location. The rate of distant metastasis is higher when the tumor invades the oropharynx or nasal cavity. The metastatic site can be single or multiple. Common distant metastasis sites are bones, lungs, and liver. Among bone metastases, the spine, pelvis, and limbs are more common. Metastasis to the chest, abdomen, mediastinal lymph nodes, inguinal lymph nodes, etc. can also occur. CT examination can detect metastasis to the kidneys, adrenal glands, and retroperitoneum at an early stage.