Synchronous nasopharyngeal carcinoma (NPC) with glioma. A 30-year old man (patient 19) suffered from headache and nasal obstruction for 6 months. On magnetic resonance (MR) images, a mass in the left lateral side and the roof of nasopharynx (arrowhead in a and b) was found. Moreover, a heterogeneously enhanced lesion was demonstrated in the left frontal lobe (arrow in a and b). Histological diagnosis was undifferentiated non-keratinizing carcinoma for the mass in the nasopharynx, and glioblastoma multiforme for the left frontal lobe lesion. A 37-year old man (patient 20) presented with epistaxis for 2 months. The MR scan demonstrated a mass in the right lateral side and the roof of the nasopharynx (arrows in c: axial contrast-enhanced MR). In addition, a left frontal lesion with hypodensity on T1-weighted images and hyperintensity on T2-weighted images (arrows in d: axial T2-weighted MR), but without gadolinium enhancement, was synchronously found on the MR scan. Endoscopic biopsy revealed a non-keratinizing NPC. Subtotal resection of the left frontal lesion was achieved and postoperative histological examination established the diagnosis of World Health Organization grade II astrocytoma.