Head and neck tumors

1. Primary cancer (1) If the focus of nasal bleeding and nasal bleeding is located on the top and back wall of the nasopharynx, when forcefully aspirating the nasal cavity or part of the nasopharynx, mild cases can cause nasal bleeding (i.e. blood in the sputum during nasal suction), and severe cases can cause nasal bleeding. Ulceration or cauliflower type on the surface of the tumor is common, while submucosal type is rare in cases of mucus bleeding. (2) Ear symptom tumors are located in the pharyngeal recess or the occipital area of the eustachian tube. Due to tumor infiltration, the pharyngeal opening of the eustachian tube is compressed, resulting in symptoms and signs of secretory otitis media, such as tinnitus, hearing loss, etc. Many nasopharyngeal cancer patients are found clinically due to ear symptoms. (3) Nasal symptoms: Primary cancer infiltrating the posterior nostril area can cause mechanical obstruction, and tumors located on the anterior wall of the nasopharynx are more likely to cause nasal congestion. Nasal congestion accounted for 15.9% of the initial symptoms and 48.0% at the time of diagnosis. (4) Headache is a common symptom. Clinically, it is often manifested as unilateral persistent pain, mostly located in the temporal and parietal regions. (5) Although it is already in the advanced stage when nasopharyngeal carcinoma invades the orbit or nerves related to the eyeball, some patients still seek medical attention based on this symptom. Nasopharyngeal cancer often causes the following symptoms and signs when it invades the eyes: visual impairment (which can lead to blindness), visual field loss, diplopia, proptosis and limited movement of the eyeball, and nerve paralysis keratitis. Atrophy and edema of the optic nerve can be seen during fundus examination. (6) Symptoms of brain nerve damage: During the process of nasopharyngeal carcinoma infiltrating the surrounding area, the trigeminal nerve, abductor nerve, glossopharyngeal nerve, and hypoglossal nerve are more affected, while the olfactory nerve, facial nerve, and auditory nerve are less affected. (7) Cervical lymph node metastasis: The enlarged lymph nodes in the neck are painless and hard, movable in the early stage, and fixed by adhesion to the skin or deep tissues in the late stage. (8) Individual cases of distant metastasis seek medical attention with distant metastasis as the main complaint. (9) Cachexia can lead to death due to systemic organ failure, as well as sudden massive bleeding. 2. Nasopharyngeal cancer combined with dermatomyositis is a serious connective tissue disease. The relationship between malignant tumors and dermatomyositis is not yet clear, but the incidence of malignant tumors in patients with dermatomyositis is at least five times higher than in normal individuals. Therefore, for patients with dermatomyositis, careful systemic examination is necessary to detect hidden malignant tumors. 3. Recessive nasopharyngeal carcinoma with enlarged lymph nodes in the neck confirmed by pathological sections as metastatic cancer, but multiple examinations or biopsies of suspicious areas still fail to detect the primary cancer lesion, is called head and neck occult cancer (cases where the primary lesion is located in the chest, abdomen, or pelvic cavity do not belong to this category).