Metastatic pathways of advanced nasopharyngeal carcinoma

Nasopharyngeal carcinoma refers to a malignant tumor that occurs in the nasopharyngeal mucosa. The disease is regional in nature and is most common in Guangdong, Guangxi, Fujian, Hunan and other places in my country. It is mainly related to Epstein-Barr virus infection. It is more common in males than females. Most of the patients are middle-aged, but some are teenagers. 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. Blood transfer

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.