ABSTRACT
We reported and analyzed an unusual case of NPC [Nasopharyngeal carcinoma] where the patient had initial clinical features of cavernous sinus involvement followed by trigeminal neuralgia and middle ear dysfunction. In the present case, the initial involvement of the cavernous sinus resulted in the left sided third nerve involvement. Later on, the extension of the tumor in and around the trigeminal ganglion resulted in facial pain. Up to that point in time, a possibility of cavernous sinus lesion was considered and this caused a delay in the diagnosis. In accordance with the literature, this case illustrates that the tumor is difficult to diagnose during the early stages for multiple reasons, including: the non-specificity of the initial symptoms and the difficulty of examining the postnasal space