Introduction/Background Nasopharyngeal carcinoma is the most commonly diagnosed head and neck cancer in Southern Asia. Lymphatic drainage of the nasopharynx is predominantly to the cervical lymph nodes. Patients are presented mostly with cervical region lymph metastasis. Radiation therapy is the main corner of the treatment. distant metastasis of nasopharyngeal carcinoma is commonly metastasis to bone, liver, lung and distant lymph nodes. In this video presentation, we present a case of isolated pelvic lymph node metastasis of nasopharyngeal carcinoma after 1-year disease-free period.

Methodology a 42 year old women diagnosed with a non-keratinizing squamous cell type of nasopharyngeal carcinoma was treated with radiotherapy admitted to gynecologic oncology unit. After 1 year disease-free period Pet-Ct showed an isolated pelvic lymph node recurrence. Laparoscopic excision of bulky lymph node was planned.

Results Step 1: Preparation of retroperitoneal spacesStep 2: Isolation of umbilical artery and n.obturatorius Step 3: Isolation of external iliac artery and veinStep 4: Excision of bulky lymph node

Conclusion The patient was discharged 24 hours after surgery. The pathological evaluation showed metastasis of nasopharyngeal carcinoma. Patient was treated with systemical chemotherapy after surgery.