Trismus as a rare presenting symptom in a pediatric nasopharyngeal carcinoma

Nasopharyngeal carcinoma (NPC) has a diverse incidence pattern but remains a rare tumour in the pediatric\udage group. Childhood nasopharyngeal carcinoma usually presents in the second decade of life.\udPaediatric NPC cases present a diagnostic challenge due to the high prevalence of common NPC presenting\udsymptoms of nasal obstruction, serous otitis media and hearing problems among children.\udFurthermore, adenoid tissue is most often present, and a biopsy in an outpatient setup would be difficult.\udHowever, trismus on initial presentation is uncommon, and even in adults is a therapy related complication.\udAs such, surgeons should have a high index of suspicion in NPC endemic areas, and a lower threshold\udfor imaging in these cases as overall outcome appeared to be similar between adult and childhood NPC