Undifferentiated Nasopharyngeal Carcinoma Presenting withShoulder Mass

Nasopharyngeal cancer (NPC) is the most common cancer among head and neck cancer that usually presented with unilateral neckmass. Unusual symptoms of NPC can lead us to diagnosis misleading and delayed definitive treatment. We present a case of NPCwith bone metastasis in the shoulder. A 33-year-old female presented with right shoulder mass caused by undifferentiatedcarcinoma of unknown primary, based on biopsy of shoulder mass. After four months, she was complaining painless neckswelling, headache, and hearing impairment in the left ear. Bone MRI showed malignant bone tumour in the right humerus.Neck CT scan showed mass in the nasopharyngeal and bilateral lymphadenopathy. Biopsy in nasopharyngeal revealedundifferentiated carcinoma of nasopharyngeal cancer (WHO-3 type A). The patient was diagnosed as NPC stage IVb and thuswas treated with palliative chemotherapy. After three cycles of cisplatin docetaxel, patient condition improved