No cancer cells in nasopharynx but metastasis to lymph nodes. An 80-year-old man from Changhua was diagnosed with stage 4 nasopharyngeal cancer

2026/09/25 09:51

The old man surnamed Chen had no cancer cells in his nasopharynx. As a result, the cancer cells had grown to his lymph nodes. (Provided by Changhua Hospital)

[Reporter Yan Hongjun/Changhua Report] An 80-year-old patient named Chen from Changhua County developed a tumor on the left side of his neck. It felt like a whole bunch of grapes. Because it was neither painful nor itchy, he did not actively seek medical treatment. There were no cancer cells in his nasopharynx, but all of them metastasized to the lymph nodes. It wasn't until his legs were swollen that he couldn't stand that he went to the hospital for a check-up and was diagnosed with stage four nasopharyngeal cancer. After chemotherapy and radiotherapy, the condition was under control.

The patient surnamed Chen has been a smoker for 50 years and chewed betel nut when he was young. About a year ago, he first felt a small tumor on the right side of his neck. A few months later, more and more tumors appeared on the left side of his neck. More than 10 grape-like tumors grew on the left side of his neck. They were neither itchy nor painful. He did not take it seriously. He did not see a doctor until his legs were swollen and he was weak. He was referred to Changhua Hospital of the Ministry of Health and Welfare for treatment.

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Xu Jiafang, deputy director of Changhua Hospital and an otolaryngologist, said that endoscopy and nasopharyngeal pathology sections showed that the patient surnamed Chen had no cancer cells in his nasopharynx. A blood test showed that EBV DNA in the blood was as high as 1,430 copies/ml (normal: 0). The medical community has confirmed that EBV DNA is a highly sensitive and specific biomarker for nasopharyngeal cancer.

Xu Jiafang pointed out that the positron imaging showed that the patient's lymph node tumors appeared in the posterior pharynx, which is the most likely site for nasopharyngeal cancer to metastasize. In addition, the pathological sections of the cervical lymph nodes showed the characteristics of nasopharyngeal cancer cells, and all cancer cells metastasized to the lymph nodes. It was confirmed that this was a case of stage 4 nasopharyngeal cancer, and it passed the review of the major injury and illness application for nasopharyngeal cancer.

Xu Jiafang said that nasopharyngeal cancer is a common malignant tumor at the junction of the throat and back of the nose. It mostly occurs in middle-aged and middle-aged people. The main causes are related to genetic inheritance, Epstein-Barr virus (EBV) infection, smoking and other environmental factors. If the patient surnamed Chen had sought medical examination earlier, he should have been able to find cancer cells in the nasopharynx. Later, they may all have metastasized without being discovered. It is also possible that the cancer cells in the primary site have been suppressed by the immune system and completely subsided, making it difficult to judge the condition.

Nasopharyngeal cancer cells can easily spread to the lymph nodes in the neck. Many patients often find one or more painless and immovable lumps in their necks before seeking medical attention. Xu Jiafang suggested that if a lump appears in the neck, painless lumps are more dangerous than painful lumps, so you must seek medical treatment as soon as possible to clarify whether it is benign or malignant.

The orthosonography showed a cluster of lymph node tumors on the left neck. (Provided by Changhua Hospital)