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Malignant Neoplasm of the Nasopharynx B022

Document
Last amended 
26 September 2017
Current RMA Instruments
Reasonable Hypothesis SOP25 of 2011
Balance of Probabilities SOP 26 of 2011
Changes from previous Instruments

SOP Bulletin 150

ICD Coding

  • ICD-9-CM Codes: 147
  • ICD-10-AM Codes: C11
Brief description

Malignant neoplasm of the nasopharynx is a primary malignancy of the mucosa of the nasopharynx, which is that part of the pharynx which lies above the level of the soft palate. This definition excludes soft tissue sarcoma, carcinoid tumour, non-Hodgkin’s lymphoma and Hodgkin’s lymphoma.

Confirming the diagnosis

Confirmation of the diagnosis requires histology (from a biopsy or surgical specimen).

The relevant medical practitioner is an Ear, Nose and Throat surgeon.

Additional diagnoses covered by SOP

  • squamous cell carcinoma of the nasopharynx
  • lymphoepithelioma (obsolete term for nasopharyngeal carcinoma)
  • nasopharyngeal carcinoma
  • undifferentiated carcinoma of the nasopharynx
Conditions not covered by SOP
  • Carcinoid tumour of nasopharynx#
  • Hodgkin’s lymphoma of the nasopharynx*
  • Malignant neoplasm of the oropharynx or hypopharynx*
  • Malignant neoplasm of the sinus (maxillary, ethmoid, frontal or sphenoidal)#
  • non-Hodgkin’s lymphoma of the nasopharynx*
  • soft tissue sarcoma of the nasopharynx*
  • Secondary/metastatic cancer/carcinoma involving the nasopharynx (code to primary cancer site)

* another SOP applies 

# non-SOP condition

Clinical onset

The most common presenting complaints are headache, diplopia, or facial numbness, caused by cranial nerve involvement, and a mass in the neck, due to cervical node metastases. Nasal obstruction with epistaxis may also occur. Once diagnosis has been confirmed, it may be possible to backdate clinical onset to when relevant symptoms first developed. 

Clinical worsening

The only worsening factor is for inability to obtain appropriate clinical management. Specialist advice will generally be required to determine if worsening due to such inability has occurred.