**9. Summary**

Nasopharyngeal carcinoma is a relatively rare neoplasm with a characteristic geographic and ethnic distribution. It most commonly arises in the lateral pharyngeal recess, and has a tendency to invade widely and metastasize. Cervical lymphadenopathy is very common at presentation and is a common presenting complaint.

Diagnosis of NPC can be made on endoscopically-guided biopsy, but effective treatment of NPC requires an accurate mapping of tumor volume and extent with imaging. Imaging allows for evaluation of tumour extent, including submucosal, osseous, and intracranial tumour spread which cannot be assessed clinically or endoscopically. Staging of NPC is based on the new 2010 AJCC guidelines. MRI is the best tool for assessing tumour extent under the current staging system, while high-resolution CT has value for assessing cortical bone erosion and PET/CT is emerging as the most accurate modality for assessing distant metastases and recurrence.

A thorough understanding of the anatomy of the nasopharynx and surrounding structures, as well as the natural history of the disease and patterns of spread, allows for accurate tumour mapping and treatment planning.
