Nasopharyngeal carcinoma NPC is an uncommon cancer in most parts of the world. There is a distinct geographical distribution with low incidence in Europe and the United States. Intermediate incidence rates are found in the Mediterranean Basin and the Arctic and in certain places such as southern China and Southeast Asia, the incidence rises significantly and these areas are considered endemic for NPC with 80% of the global burden in Asian countries. The standard of care for these patients consists of concurrent chemoradiotherapy with cisplatin-based regimens, generally followed by adjuvant chemotherapy. This treatment approach results in cure for the vast majority of patients, with 3-year disease-free and overall survival rates of approximately 70% and 80%, respectively. Distant metastases are present in 3% to 6% of the cases and may occur in 18% to 50% of cases during the disease course. The most common sites for distant NPC metastases are the bone, lung, and liver. Brain and skin metastases rarely occur.