Differential diagnosis of nasopharyngeal tumors by computed tomography scanning.

While direct visual or even fiberoptic endoscopic examination of the nasopharynx may at times be diagnostic, some limitations are frequently encountered as follows: (1) determination of the extent of submucosal spread, (2) identification of intracranial extensions, (3) in some instances, the differentiation of benign from malignant processes, and (4) the delineation of aggressive inflammatory processes such as Wegener's granulomatosis or mucormycosis. Seventy patients were reviewed to determine what help could be anticipated from computed tomography scanning. Low-density fascial planes are readily identified in the paranasopharyngeal space that provide important clues to the spread and diagnosis of malignant disease or aggressive inflammatory processes. The use of intravenous contrast material for enhancement of intracranial spread of tumors or for identification of the margins of hypervascular lesions can be quite helpful.