Computed tomography of the nasopharynx and related spaces. Part II: Pathology.

Malignant tumors of the nasopharynx were analyzed by region of origin and route of spread. Nasopharyngeal carcinomas produced early submucosal infiltration of the deglutitional muscle layer with enlargement of the levator palati muscle and lateral displacement of the parapharyngeal space. Serous otitis media was frequently associated, and the trigeminal nerve was occasionally involved. Intracranial extension via the foramen lacerum was frequent. Metastases to the infratemporal fossa produced early involvement of the masticatory muscle layer with medial displacement of the parapharyngeal space. Adenoid cystic carcinomas showed late but disproportionate involvement of the sphenoid sinus. Chordomas extended into the retropharyngeal soft tissues via the petro-occipital fissure. Maxillary sinus carcinomas, which were very large at the time of presentation and impinged on the nasopharynx, showed extensive destruction of the pterygoid plates.