Epiglottic Metastasis from a Recurrent Nasopharyngeal Carcinoma: A Rare Manifestation

Abstract

Nasopharyngeal carcinoma (NPC) is the third most common malignancy among men in Malaysia, accounting for about 8.1% of cases. This malignancy is shown to be occurring from a complex interplay between environmental, genetic and viral factors. The presence of distant metastasis affects the rate of survival in many types of malignancy. This is especially true in nasopharyngeal cancers, where there is a higher risk of distant metastases compared to other types of head and neck malignancies. We report a case of a 65-year-old man with recurrent nasopharyngeal carcinoma, presented with an unusual metastasis over the epiglottis. The patient came with complaints of hoarseness and blood-stained sputum for the past few months. On examination, he had hoarseness with an irregular, suspicious mass at the epiglottis. Endoscopic laryngeal microsurgery was done and the histopathology report confirmed a recurrent NPC of undifferentiated type. This case illustrates the diagnostic challenges faced by clinicians when approaching patients with post-NPC treatment.