Nasopharyngeal mass in paediatric population is usually benign and malignant nasopharyngeal tumours such as carcinoma is rare. We report a case of nasopharyngeal carcinoma (NPC) in an adolescent with atypical imaging findings that mimicked a benign mass. This highlights the importance of a comprehensive review on the distinctive radiographic features of paediatric nasopharyngeal mass. We discuss the imaging features of NPC in the paediatric group, which differ from the elderly patients. By recognising these distinctive imaging features, it may help in diagnosing typical case. This case report serves as a reminder that NPC, despite being uncommon, should be considered in the differential diagnosis of a juvenile nasopharyngeal mass.