This teenage patient presented with advanced nasopharyngeal metastatic disease. 

The case demonstrates the combined value to MRI and CT in head and neck malignancies, especially those involving the skull base.

The anatomical spaces of the head and neck are well demonstrated on this case in particular the sphenopalatine foramen and pterygopalatine fossa, as the tumor extends into the expands these spaces.

Ultrasound guided biopsy of the neck node was undertaken.

HISTOLOGY: Metastatic undifferentiated carcinoma