Due to anatomic restrictions and presentation with advanced local-regional diseases, radiotherapy has provided the standard of care for nasopharyngeal cancer. Although the local recurrence after curative radiation therapy has been often reported in the literature, reports of changes in the histopathologic findings of the tumor in the nasopharyngeal carcinoma are rare. Due to limitation in surgical treatment of nasopharyngeal carcoma, radiotherapy has been standard treatment for nasopharyngeal carcinoma. We present a case of multiple complications after radiotherapy in patients with the second primary nasopharyngeal cancer following a change in the histopathologic findings.ope