Background: Extranodal NK/T-cell lymphoma (NKTCL), nasal type (ENKL) is extremely rare in children and adolescents. It is mostly seen in male adults with 4th to 5th decades and the prognosis is variable. The main clinical features are nasal congestion, sore throat, dysphagia and epistaxis due to a destructive mass involving the midline facial tissues. We report herewith a case of incidentally diagnosed ENKL in an adolescent boy who was treated with concurrent chemoradiotherapy (CCRT). Case report: A 13-year-old boy presented with a 1 cm-sized palpable cervical lymph node (LN). He didn’t suffer from any nasal symptoms such as nasal congestion, sore throat, dysphagia or epistaxis. There was no palpable organomegaly or other lymphadenopathy. Neck US showed a LN of 3.5 cm in length, which was excised. The pathology was reactive lymphadenitis. A necrotic mass in the nasopharynx was incidentally detected on laryngoscopic examination. The microscopic findings were compatible with an ENKL with positive findings for CD3, CD 16, granzyme B, TIA and EBV, but negative for CD56 by immunohistochemical stains. He underwent CCRT of 45 Gy intensity-modulated radiation therapy to local lesion and 3 cycles of 2/3 DeVIC chemotherapy consisting with dexamethasone (40 mg/day for 3 days), ifosfamide (1000 mg/m2/day for 3 days), VP-16 (67 mg/ m2/day for 3 days) and carboplatin (200 mg/ m2 for 1day). He remains disease-free without significant side effects. Conclusion: An ENKL, although rare, should be considered in children and adolescents when unusual necrotic lesion is seen on nasopharynx. As there are no consensus in the management for ENKL in children and adolescents, the treatment plan was extrapolated from adult experiences. Thus, a prospective, collaborative study including larger number of cases is warranted.