Nasopharyngeal carcinoma masquerading as refractory odontogenic pain: a case report

Nasopharyngeal carcinoma is a malignancy arising from the epithelial lining of the nasopharynx. Although early detection is critical for favorable outcomes, achieving timely diagnosis remains challenging due to the condition’s non-specific initial symptoms. This case highlights the necessity for dental practitioners to maintain a high index of suspicion for nasopharyngeal carcinoma when evaluating patients with unexplained toothache or oral bleeding. A 40-year-old female patient presented to the Department of Oral Medicine with a chief complaint of blood-tinged saliva for 6 months and pain in the left lower posterior tooth for 3 months. The final diagnosis, confirmed by MRI and biopsy, was nasopharyngeal carcinoma. The patient’s symptoms resolved after chemoradiotherapy. For patients with unexplained oral bleeding and toothache, particularly when these symptoms are unilateral, refractory to conventional dental treatment, or accompanied by otological manifestations such as hearing loss, tinnitus, or ear fullness, as well as neurological deficits including blurred vision or facial numbness, dentists should recognize these as potential red flags for nasopharyngeal carcinoma.