Tuberculosis a Diagnostic Pitfall of Nasopharyngeal Carcinoma? Two Case Report

Nagaland has the highest AAR (age adjusted rates) of Nasopharyngeal carcinoma (NPC) in India. The frequent presentation of metastatic neck nodes of nasopharyngeal carcinoma can lead to diagnostic errors if preliminary investigations are not done properly. We present two patients with metastatic NPC who were initially treated with anti-tubercular therapy presumed to have tuberculosis. Metastasis was confirmed with fine needle aspiration cytology and NPC diagnosis was made on histopathological examination of endoscopic nasal biopsy. Both patients were treated with neoadjuvant chemotherapy, followed with concurrent chemo-radiation and are on follow-up.