Question:hard
All of the following statements about nasopharyngeal carcinoma are true, except:
All of the following statements about nasopharyngeal carcinoma are true, except:
Show Hint
The nasopharynx is deep and the tumour is radiosensitive, so the primary treatment is not surgery.
Updated On: Jun 24, 2026
- Bimodal age distribution
- Nasopharyngectomy with radical neck dissection is the treatment of choice
- IgA antibody to EBV is observed
- Squamous cell carcinoma is the most common histological subtype
Show Solution
The Correct Option is B
Solution and Explanation
This negative stem asks for the one untrue claim about nasopharyngeal carcinoma. The disease starts high in the nasopharynx, classically in the fossa of Rosenmuller, and carries strong ties to Epstein-Barr virus and to dietary and ethnic factors seen in southern China and Southeast Asia.
Looking at the options, the bimodal age pattern is genuine; there is an early peak in young people and a larger later peak in middle age, so that statement stands. The presence of IgA antibodies to EBV is also real and clinically useful, since elevated anti-VCA and anti-EA IgA titres help detect and monitor the tumour. The histology statement is correct as well, because the tumour is fundamentally squamous, grouped by the WHO into keratinising, non-keratinising and undifferentiated forms, with the undifferentiated variety dominating in endemic regions.
The statement that fails is the one about surgery. Because the nasopharynx sits deep at the skull base where wide excision is impractical, and because the tumour responds extremely well to irradiation, radiotherapy is the mainstay, with concurrent chemotherapy for advanced stages. A radical nasopharyngectomy with neck dissection is not the primary treatment; surgery on the neck is only for nodal disease that persists after radiation. Therefore this surgical claim is the exception.
\[\boxed{\text{Nasopharyngectomy with radical neck dissection is the treatment of choice (false)}}\]
Looking at the options, the bimodal age pattern is genuine; there is an early peak in young people and a larger later peak in middle age, so that statement stands. The presence of IgA antibodies to EBV is also real and clinically useful, since elevated anti-VCA and anti-EA IgA titres help detect and monitor the tumour. The histology statement is correct as well, because the tumour is fundamentally squamous, grouped by the WHO into keratinising, non-keratinising and undifferentiated forms, with the undifferentiated variety dominating in endemic regions.
The statement that fails is the one about surgery. Because the nasopharynx sits deep at the skull base where wide excision is impractical, and because the tumour responds extremely well to irradiation, radiotherapy is the mainstay, with concurrent chemotherapy for advanced stages. A radical nasopharyngectomy with neck dissection is not the primary treatment; surgery on the neck is only for nodal disease that persists after radiation. Therefore this surgical claim is the exception.
\[\boxed{\text{Nasopharyngectomy with radical neck dissection is the treatment of choice (false)}}\]
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