A 29-year-old man with no personal or family history of interest came to our clinic to assess a left cervical mass of progressive growth and several months of evolution, which produces dysphonia, dry cough and dyspnea.
The patient denied weight loss, asthenia or anorexia, and profuse non-turnal sweating, as well as frequent holocraneal headache.
The exploration revealed a hard mass adhered to deep planes in the lower left cervical third, extending to the midline, extending towards locoregional lymph nodes.
Computed tomography (CT) reveals a 7 x 2 cm tumor, from the left thyroid lobe to the aortic arch, which produces some tracheal stenosis and esophageal displacement.
Histological sections show connective tissue infiltrated in certain areas by a neoplasm with large numbers of cells of small or intermediate size.
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In the immunohistochemical study, tumor cells are reactive exclusively to CD99, neurospecific enolase and weakly to synaptophysin.
The nuclear positivity for the Ki-67 proliferation antibody ranges between 25% and 50% of the nuclei of tumor cells.
With the diagnosis obtained by biopsy, the patient is programmed to receive chemoradiation therapy.
She received 4 cycles of chemotherapy, followed by radiotherapy with a total dose of 55.8 Gy, after which she developed colitis and epithelitis grade 2.
After radiotherapy, the patient received 6 cycles of multidrug therapy.
The days after the start of treatment, the patient presented a progressive improvement in her respiratory stridor, which disappeared completely, as well as a decrease in the size of the laterocervical tumor greater than 50%.
Complete remission of the disease was observed after completion of all treatment cycles.
The asymptomatic patient remained asymptomatic for 7 years until he came to the consultation complaining of dyspnea and cough of a month of evolution and CAT scan showed mediastinal recurrence with pulmonary extension.
Sepsis was performed due to tracheal compression of the tumor and cytotoxic treatment was initiated with 4 cycles of polychemotherapy.
The patient survived for one year until his death from a tumor.
