Snap Shot A 64-year-old man presents with a 2-cm lesion on his pharynx and two palpable lymph nodes in the left side of his neck. No other disease exists Presentation Epidemiology smokers drinkers Presentation hoarseness difficulty swallowing otalgia hemoptysis non-healing oral ulcer Treatment Diagnosis involves direct visualization and tissue biopsy Treatment is excision of the tumor and radical neck disection in the presence of clinically palbable nodal disease Radical neck disection removes the sternocleidomastoid muscle, internal jugular vein, submaxillary gland, and spinal accessory nerve, and leaves the carotid artery and its branches Nasopharyngeal Carcinoma Diagnosis involves direct visualization and tissue biopsy The biopsy is suggestive of carcinoma involving features suggestive of epithelial cells Undifferentiated cells found on biopsy are also suggestive of nasopharyngeal carcinoma (undifferentiated type) Strong association with EBV, smoking, and salt-preserved food Most common in Southern Chinese (and other Asian) populations Treatment is excision of the tumor and radical neck disection in the presence of clinically palbable nodal disease