Metastatic Nasopharyngeal Carcinoma Presenting with Palpable Neck Nodes-a Look at Clinical Presentation and Literature Review on Screening

: Nasopharyngeal carcinoma in Nagaland has the highest age adjusted rates for both men (14.4 /100,000) and women (6.5 /100,000) in India. Most of the patients presents with usual vague symptoms related to mass in nasal cavity and higher clinical stage which affects the treatment outcome. The aim of this study is to present 34 cases of patients with Nasopharyngeal carcinoma initially presenting with palpable neck nodes and discuss the clinical findings and literature review on screening methodology with focus on Plasma EBV DNA.: Retrospective analysis of all cases of metastatic nasopharyngeal carcinoma diagnosed by Fine needle aspiration cytology on palpable cervical lymph node and histologically confirmed by endoscopic biopsy.: Total of 34 cases were included with 23 men and 11 women. The age ranged from 16 to 79 years with average of 46.6 years. The most common clinical presentation was painless neck swelling followed by epistaxis. 33/34 cases are of Non keratinizing undifferentiated nasopharyngeal carcinoma. Majority of the cases presented in stage III (19/34) followed by stage IV (10/34). : Nasopharyngeal carcinoma is a major health problem in Nagaland. Development of a good NPC screening protocol including molecular techniques remains to be explored, in order to develop and contribute to the early detection of the disease and a favourable treatment outcome.