• Chih-Hsuan Shen, Shih-Lun Chang, and Sheng-Tsung Chang.
• Department of Otorhinolaryngology, Chi Mei Medical Center, Tainan, Taiwan.
• Medicine (Baltimore). 2021 Nov 5; 100 (44): e27729e27729.

RationalePrimary nasopharyngeal papillary adenocarcinoma is a rare nasopharyngeal neoplasm with a good prognosis and a low propensity for regional recurrence. To date, only few cases of primary nasopharyngeal papillary adenocarcinoma have been reported in the literature.Patient ConcernsA 24-year-old female patient presented with intermittent hemoptysis and blood tinge nasal discharge.DiagnosisAn exophytic and pedunculated mass over the roof of the nasopharynx was found on nasopharyngoscope. Biopsy was done and the pathology confirmed well-differentiated primary nasopharyngeal papillary adenocarcinoma, strongly positive for CK7, and transcription termination factor 1; but negative for thyroglobulin. The final diagnosis was primary nasopharyngeal papillary adenocarcinoma, well-differentiated, pT1N0M0, stage I.InterventionsThe patient underwent excision of nasopharyngeal tumor under sinuscopic assistance.Outcomes: No local recurrence or distant metastasis was noted during the 6 months of follow-up.LessonsWe aim at highlighting the importance of a thorough differential diagnosis of nasopharyngeal tumor. Further investigation is still needed for providing evidence to standardize the treatment protocol.Copyright © 2021 the Author(s). Published by Wolters Kluwer Health, Inc.

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