Descriptive Analysis of Symptomatic Nasopharyngeal Masses

Objective: Symptomatic nasopharyngeal masses can represent a wide range of pathological entities, both benign and malignant. Accurate identification and diagnosis are critical for guiding appropriate clinical management. These lesions often pose a diagnostic challenge due to their variable and possibly delayed presentation. This study provides a descriptive analysis of 27 cases of symptomatic nasopharyngeal masses at our institution, with the aim of further improving diagnostic accuracy and treatment strategies. Methods: A retrospective, single-center review of 27 patients with symptomatic nasopharyngeal masses who presented to our institution between 2015 and 2023. Patient demographics, presenting symptoms, endoscopic findings, and anatomical tumor location were assessed among cases biopsied in the operating room. Results: Twenty-seven patients presented to our institution with symptomatic nasopharyngeal masses and underwent biopsy in the operating room. This series included 18 males (66.7%) and 9 females (33.3%), with a mean age at diagnosis of 55.1 ± 18.4 years. The most common presenting symptoms were nasal obstruction and neck/jaw pain (25.9%), followed by aural fullness, otalgia, and facial pain (22.2%); epistaxis, headache, and cranial neuropathy (18.5%); and nasal congestion or drainage, middle ear effusion, decreased hearing or visual changes (14.8%). Masses were unilateral in 14 patients (51.9%), bilateral in 9 (33.3%), and midline in 4 (14.8%). Sixteen cases (59.2%) were benign, most commonly chronic inflammation, while 11 cases (40.8%) were malignant, including nasopharyngeal carcinoma (n=5), lymphoma (n=3), salivary gland carcinoma (n=2), and chondrosarcoma (n=1). Conclusion: Symptomatic nasopharyngeal masses exhibit a wide spectrum of clinical presentations and underlying pathologies, with a substantial proportion representing malignancy. This descriptive series highlights diagnostic patterns and anatomical trends, offering a reference for clinicians evaluating similar cases. Our findings suggest that symptomatic nasopharyngeal masses carry a higher risk of malignancy; therefore, biopsy is recommended rather than conservative follow-up. Publication History Article published online: 27 February 2026 © 2026. Thieme. All rights reserved. Georg Thieme Verlag KG Oswald-Hesse-Straße 50, 70469 Stuttgart, Germany