Spandidos Publications Logo
  • About
    • About Spandidos
    • Aims and Scopes
    • Abstracting and Indexing
    • Editorial Policies
    • Reprints and Permissions
    • Job Opportunities
    • Terms and Conditions
    • Contact
  • Journals
    • All Journals
    • Oncology Letters
      • Oncology Letters
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • International Journal of Oncology
      • International Journal of Oncology
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Molecular and Clinical Oncology
      • Molecular and Clinical Oncology
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Experimental and Therapeutic Medicine
      • Experimental and Therapeutic Medicine
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • International Journal of Molecular Medicine
      • International Journal of Molecular Medicine
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Biomedical Reports
      • Biomedical Reports
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Oncology Reports
      • Oncology Reports
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Molecular Medicine Reports
      • Molecular Medicine Reports
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • World Academy of Sciences Journal
      • World Academy of Sciences Journal
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • International Journal of Functional Nutrition
      • International Journal of Functional Nutrition
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • International Journal of Epigenetics
      • International Journal of Epigenetics
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Medicine International
      • Medicine International
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
  • Articles
  • Information
    • Information for Authors
    • Information for Reviewers
    • Information for Librarians
    • Information for Advertisers
    • Conferences
  • Language Editing
Spandidos Publications Logo
  • About
    • About Spandidos
    • Aims and Scopes
    • Abstracting and Indexing
    • Editorial Policies
    • Reprints and Permissions
    • Job Opportunities
    • Terms and Conditions
    • Contact
  • Journals
    • All Journals
    • Biomedical Reports
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Experimental and Therapeutic Medicine
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • International Journal of Epigenetics
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • International Journal of Functional Nutrition
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • International Journal of Molecular Medicine
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • International Journal of Oncology
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Medicine International
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Molecular and Clinical Oncology
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Molecular Medicine Reports
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Oncology Letters
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Oncology Reports
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • World Academy of Sciences Journal
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
  • Articles
  • Information
    • For Authors
    • For Reviewers
    • For Librarians
    • For Advertisers
    • Conferences
  • Language Editing
Login Register Submit
  • This site uses cookies
  • You can change your cookie settings at any time by following the instructions in our Cookie Policy. To find out more, you may read our Privacy Policy.

    I agree
Search articles by DOI, keyword, author or affiliation
Search
Advanced Search
presentation
Experimental and Therapeutic Medicine
Join Editorial Board Propose a Special Issue
Print ISSN: 1792-0981 Online ISSN: 1792-1015
Journal Cover
October-2026 Volume 32 Issue 4

Full Size Image

Sign up for eToc alerts
Recommend to Library

Journals

International Journal of Molecular Medicine

International Journal of Molecular Medicine

International Journal of Molecular Medicine is an international journal devoted to molecular mechanisms of human disease.

International Journal of Oncology

International Journal of Oncology

International Journal of Oncology is an international journal devoted to oncology research and cancer treatment.

Molecular Medicine Reports

Molecular Medicine Reports

Covers molecular medicine topics such as pharmacology, pathology, genetics, neuroscience, infectious diseases, molecular cardiology, and molecular surgery.

Oncology Reports

Oncology Reports

Oncology Reports is an international journal devoted to fundamental and applied research in Oncology.

Experimental and Therapeutic Medicine

Experimental and Therapeutic Medicine

Experimental and Therapeutic Medicine is an international journal devoted to laboratory and clinical medicine.

Oncology Letters

Oncology Letters

Oncology Letters is an international journal devoted to Experimental and Clinical Oncology.

Biomedical Reports

Biomedical Reports

Explores a wide range of biological and medical fields, including pharmacology, genetics, microbiology, neuroscience, and molecular cardiology.

Molecular and Clinical Oncology

Molecular and Clinical Oncology

International journal addressing all aspects of oncology research, from tumorigenesis and oncogenes to chemotherapy and metastasis.

World Academy of Sciences Journal

World Academy of Sciences Journal

Multidisciplinary open-access journal spanning biochemistry, genetics, neuroscience, environmental health, and synthetic biology.

International Journal of Functional Nutrition

International Journal of Functional Nutrition

Open-access journal combining biochemistry, pharmacology, immunology, and genetics to advance health through functional nutrition.

International Journal of Epigenetics

International Journal of Epigenetics

Publishes open-access research on using epigenetics to advance understanding and treatment of human disease.

Medicine International

Medicine International

An International Open Access Journal Devoted to General Medicine.

Journal Cover
October-2026 Volume 32 Issue 4

Full Size Image

Sign up for eToc alerts
Recommend to Library

  • Article
  • Citations
    • Cite This Article
    • Download Citation
    • Create Citation Alert
    • Remove Citation Alert
    • Cited By
  • Similar Articles
    • Related Articles (in Spandidos Publications)
    • Similar Articles (Google Scholar)
    • Similar Articles (PubMed)
  • Download PDF
  • Download XML
  • View XML

  • Supplementary Files
    • Supplementary_Data.pdf
Case Report Open Access

Nasopharyngeal carcinoma with inguinal lymph node metastasis: A case report

  • Authors:
    • Zhibin Lin
    • Shiliang Li
    • Donghong Yang
    • Tongyuan Deng
    • Haiwen Li
    • Yongcun Wang
  • View Affiliations / Copyright

    Affiliations: Department of Oncology, People's Hospital of Yangjiang, Yangjiang, Guangdong 529500, P.R. China, The First Clinical Medical School, Guangdong Medical University, Zhanjiang, Guangdong 524000, P.R. China, Department of Head and Neck Oncology, Affiliated Hospital of Guangdong Medical University, Zhanjiang, Guangdong 524000, P.R. China, Department of Pulmonary Oncology, Affiliated Hospital of Guangdong Medical University, Zhanjiang, Guangdong 524000, P.R. China
    Copyright: © Lin et al. This is an open access article distributed under the terms of Creative Commons Attribution License.
  • Article Number: 262
    |
    Published online on: August 4, 2026
       https://doi.org/10.3892/etm.2026.13257
  • Expand metrics +
Metrics: Total Views: 0 (Spandidos Publications: | PMC Statistics: )
Metrics: Total PDF Downloads: 0 (Spandidos Publications: | PMC Statistics: )
Cited By (CrossRef): 0 citations Loading Articles...

This article is mentioned in:


Abstract

Nasopharyngeal carcinoma (NPC) usually metastasizes to cervical lymph nodes, whereas inguinal lymph node metastases (ILNM) are rare, with only a small number of cases reported. ILNs are an uncommon site of secondary involvement, a phenomenon attributed to their unique anatomical and immunological features. The current study reported a case of NPC in which baseline positron emission tomography/CT showed metastasis from the left pharyngeal recess to the left cervical levels II‑III. Mildly increased metabolic activity was observed in levels II‑III of the right cervical chain, the left supraclavicular area and the bilateral inguinal area, initially interpreted as reactive hyperplasia. The patient was diagnosed with NPC (T2N1M0, stage IIA, 8th edition of the American Joint Committee on Cancer). At 5 months after the completion of induction chemotherapy and concurrent chemoradiotherapy, the bilateral ILNs showed interval enlargement and biopsy confirmed metastatic NPC. The patient was classified as stage IVB based on biopsy results, prompting appropriate treatment for this advanced stage. This rare case underscores the importance of considering ILNM as a possible metastatic site in NPC, requiring clinicians to perform timely evaluations and lymph node biopsies to prevent clinical understaging due to unrecognized occult metastatic disease, particularly during the early stages of diagnosis.
View Figures

Figure 1

Histopathological analyses of primary
and metastatic lesions (magnification, x200). Pathological
diagnosis: Primary nasopharyngeal non-keratinizing carcinoma. (A)
Tumor cells, arranged in nests within desmoplastic stroma,
exhibited vesicular nuclei with prominent nucleoli and abundant
cytoplasm (hematoxylin and eosin staining). (B) EBER in situ
hybridization was positive. (C) EGFR showed weak positivity and
Ki-67 positivity was 20-30%. (D) Neoplastic cells were CK
immunoreactive. Left inguinal lymph node tissue: (E) Tumor cells in
a nested or sheet-like distribution were seen in the fibrous
connective tissue, with vesicular nuclei, pronounced nucleoli and
numerous nuclear divisions (hematoxylin and eosin staining); the
morphology of the inguinal lymph node and its immunohistochemical
profile were consistent with non-keratinizing carcinoma, with
positive staining for (F) CK5/6, (G) EBER by in situ
hybridization and (H) EGFR. EBER, Epstein-Barr virus-encoded small
RNA; CK, cytokeratin; EGFR, epidermal growth factor receptor.

Figure 2

Imaging scans. Initial (A-D) MRI and
(E-H) PET/CT scans are presented, with the PET/CT scans compared
between pre-treatment (below) and post-treatment (above). (A)
Nasopharyngeal mucosa thickening, enlarged lymph nodes in the left
cervical lymph node regions: (B and D) RPN, levels II and III were
considered possible meta-static tumors. (C and D) Left cervical
level II lymph nodes showing extranodal extension (+). In the RPN
of the (E) nasopharynx and (F) left neck lymph nodes levels II and
III, there was no evidence of metastasis or recurrence. (G) Several
left supraclavicular lymph nodes showed interval enlargement on
follow-up PET/CT, with the largest measuring ~1.2 cm x1.0 cm and
markedly increased glucose metabolism (SUVmax=11.8), in contrast to
no abnormal uptake on baseline imaging. (H) Bilateral multiple
enlarged inguinal lymph nodes showed interval progression, with the
largest measuring ~3.5 cm x2.1 cm and markedly increased glucose
metabolism (SUVmax=6.2), compared with a prior SUVmax of 2.5 on
baseline imaging. PET, positron emission tomography; SUVmax,
maximum standardized uptake volume; RPN, retropharyngeal lymph
nodes.

Figure 3

Treatment timeline. NPC,
nasopharyngeal carcinoma; PET, positron emission tomography; VMAT,
volumetric modulated arc therapy; RECIST, Response Evaluation
Criteria in Solid Tumors; PR, partial response; S-1, a combination
of tegafur, gimeracil and oteracil potassium.
View References

1 

Bray F, Laversanne M, Sung H, Ferlay J, Siegel RL, Soerjomataram I and Jemal A: Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 74:229–263. 2024.PubMed/NCBI View Article : Google Scholar

2 

Chen YP, Chan ATC, Le QT, Blanchard P, Sun Y and Ma J: Nasopharyngeal carcinoma. Lancet. 394:64–80. 2019.PubMed/NCBI View Article : Google Scholar

3 

Lee HM, Okuda KS, González FE and Patel V: Current perspectives on nasopharyngeal carcinoma. Adv Exp Med Biol. 1164:11–34. 2019.PubMed/NCBI View Article : Google Scholar

4 

Wang X, Hu C, Ying H, He X, Zhu G, Kong L and Ding J: Patterns of lymph node metastasis from nasopharyngeal carcinoma based on the 2013 updated consensus guidelines for neck node levels. Radiother Oncol. 115:41–45. 2015.PubMed/NCBI View Article : Google Scholar

5 

Ho FCH, Tham IWK, Earnest A, Lee KM and Lu JJ: Patterns of regional lymph node metastasis of nasopharyngeal carcinoma: A meta-analysis of clinical evidence. BMC Cancer. 12(98)2012.PubMed/NCBI View Article : Google Scholar

6 

Qu W, Li S, Zhang M and Qiao Q: Pattern and prognosis of distant metastases in nasopharyngeal carcinoma: A large-population retrospective analysis. Cancer Med. 9:6147–6158. 2020.PubMed/NCBI View Article : Google Scholar

7 

Pan JJ, Ng WT, Zong JF, Chan LL, O'Sullivan B, Lin SJ, Sze HC, Chen YB, Choi HC, Guo QJ, et al: Proposal for the 8th edition of the AJCC/UICC staging system for nasopharyngeal cancer in the era of intensity-modulated radiotherapy. Cancer. 122:546–558. 2016.PubMed/NCBI View Article : Google Scholar

8 

Zhang XF, Zhang Y, Liang XW, Chen JL, Zhi SF, Yin WJ, Wang MY, Dong EL and Chen DP: Subphrenic lymph node metastasis predicts poorer prognosis for nasopharyngeal carcinoma patients with metachronous metastasis. Front Oncol. 11(726179)2021.PubMed/NCBI View Article : Google Scholar

9 

Kan Y, Yang S, Wu X, Wang S, Li X, Zhang F, Wang P and Zhao J: The quality of life in nasopharyngeal carcinoma radiotherapy: A longitudinal study. Asia Pac J Oncol Nurs. 10(100251)2023.PubMed/NCBI View Article : Google Scholar

10 

Swan MC, Furniss D and Cassell OCS: Surgical management of metastatic inguinal lymphadenopathy. BMJ. 329:1272–1276. 2004.PubMed/NCBI View Article : Google Scholar

11 

Wyatt J, Powell SG, Ahmed S, Arthur J, Altaf K, Ahmed S and Javed MA: Inguinal lymph node metastases from rectal adenocarcinoma: A systematic review. Tech Coloproctol. 27:969–978. 2023.PubMed/NCBI View Article : Google Scholar

12 

Shang Q, Zhao L, Pang Y, Yu Y and Chen H: 68Ga-FAPI PET/CT distinguishes the reactive lymph nodes from tumor metastatic lymph nodes in a patient with nasopharyngeal carcinoma. Clin Nucl Med. 47:367–368. 2022.PubMed/NCBI View Article : Google Scholar

13 

Fidler IJ and Poste G: The ‘seed and soil’ hypothesis revisited. Lancet Oncol. 9(808)2008.PubMed/NCBI View Article : Google Scholar

14 

Zhang B, Zhang H, Chen Y, Xia W and Wang Y: Supraclavicular lymph node metastasis in esophageal carcinoma: A topic of ongoing controversy. Front Oncol. 15(1527625)2025.PubMed/NCBI View Article : Google Scholar

15 

Fei Y, Lu Y, Yao Z, Yin K, Zhou D and Liu Z: Diagnostic value of multimodal lymphatic imaging techniques in thoracic duct outlet obstruction. Diagnostics (Basel). 15(1288)2025.PubMed/NCBI View Article : Google Scholar

16 

Lin M, Zhang XL, You R, Liu YP, Cai HM, Liu LZ, Liu XF, Zou X, Xie YL, Zou RH, et al: Evolutionary route of nasopharyngeal carcinoma metastasis and its clinical significance. Nat Commun. 14(610)2023.PubMed/NCBI View Article : Google Scholar

17 

Xie C, Li H, Yan Y, Liang S, Li Y, Liu L, Cui C and Liu Y: A nomogram for predicting distant metastasis using nodal-related features among patients with nasopharyngeal carcinoma. Front Oncol. 10(616)2020.PubMed/NCBI View Article : Google Scholar

18 

Peng WS, Xing X, Li YJ, Ding JH, Mo M, Xu TT, Zhou X and Hu CS: Prognostic nomograms for nasopharyngeal carcinoma with nodal features and potential indication for N staging system: Validation and comparison of seven N stage schemes. Oral Oncol. 144(106438)2023.PubMed/NCBI View Article : Google Scholar

19 

Liu W, Chen G, Gong X, Wang Y, Zheng Y, Liao X, Liao W, Song L, Xu J and Zhang X: The diagnostic value of EBV-DNA and EBV-related antibodies detection for nasopharyngeal carcinoma: A meta-analysis. Cancer Cell Int. 21(164)2021.PubMed/NCBI View Article : Google Scholar

20 

Chan KCA, Woo JKS, King A, Zee BCY, Lam WKJ, Chan SL, Chu SWI, Mak C, Tse IOL, Leung SYM, et al: Analysis of plasma Epstein-Barr virus DNA to screen for nasopharyngeal cancer. N Engl J Med. 377:513–522. 2017.PubMed/NCBI View Article : Google Scholar

21 

Chan DCT, Lam WKJ, Hui EP, Ma BBY, Chan CML, Lee VCT, Cheng SH, Gai W, Jiang P, Wong KCW, et al: Improved risk stratification of nasopharyngeal cancer by targeted sequencing of Epstein-Barr virus DNA in post-treatment plasma. Ann Oncol. 33:794–803. 2022.PubMed/NCBI View Article : Google Scholar

Related Articles

  • Abstract
  • View
  • Download
  • Twitter
Copy and paste a formatted citation
Spandidos Publications style
Lin Z, Li S, Yang D, Deng T, Li H and Wang Y: Nasopharyngeal carcinoma with inguinal lymph node metastasis: A case report. Exp Ther Med 32: 262, 2026.
APA
Lin, Z., Li, S., Yang, D., Deng, T., Li, H., & Wang, Y. (2026). Nasopharyngeal carcinoma with inguinal lymph node metastasis: A case report. Experimental and Therapeutic Medicine, 32, 262. https://doi.org/10.3892/etm.2026.13257
MLA
Lin, Z., Li, S., Yang, D., Deng, T., Li, H., Wang, Y."Nasopharyngeal carcinoma with inguinal lymph node metastasis: A case report". Experimental and Therapeutic Medicine 32.4 (2026): 262.
Chicago
Lin, Z., Li, S., Yang, D., Deng, T., Li, H., Wang, Y."Nasopharyngeal carcinoma with inguinal lymph node metastasis: A case report". Experimental and Therapeutic Medicine 32, no. 4 (2026): 262. https://doi.org/10.3892/etm.2026.13257
Copy and paste a formatted citation
x
Spandidos Publications style
Lin Z, Li S, Yang D, Deng T, Li H and Wang Y: Nasopharyngeal carcinoma with inguinal lymph node metastasis: A case report. Exp Ther Med 32: 262, 2026.
APA
Lin, Z., Li, S., Yang, D., Deng, T., Li, H., & Wang, Y. (2026). Nasopharyngeal carcinoma with inguinal lymph node metastasis: A case report. Experimental and Therapeutic Medicine, 32, 262. https://doi.org/10.3892/etm.2026.13257
MLA
Lin, Z., Li, S., Yang, D., Deng, T., Li, H., Wang, Y."Nasopharyngeal carcinoma with inguinal lymph node metastasis: A case report". Experimental and Therapeutic Medicine 32.4 (2026): 262.
Chicago
Lin, Z., Li, S., Yang, D., Deng, T., Li, H., Wang, Y."Nasopharyngeal carcinoma with inguinal lymph node metastasis: A case report". Experimental and Therapeutic Medicine 32, no. 4 (2026): 262. https://doi.org/10.3892/etm.2026.13257
Follow us
  • Twitter
  • LinkedIn
  • Facebook
About
  • Spandidos Publications
  • Careers
  • Cookie Policy
  • Privacy Policy
How can we help?
  • Help
  • Live Chat
  • Contact
  • Email to our Support Team