A 60 year old man with a long history of smoking and alcohol presents with nasal obstruction, epistaxis, diplopia, otalgia and conductive deafness. What is the single most likely diagnosis?

The key is A. Nasopharyngeal ca. [Nasal obstruction, epistaxis are features of nasopharyngeal carcinoma; with cranial nerve palsy, diplopia due to 6th nerve, (also 5th and 12th cranial nerves are frequently affected) otalgia and conductive deafness from local extension as mentioned can occur].