Ann Clin Otolaryngol | Volume 1, Issue 1 | Case Report | Open Access

Mediastinal Nonseminomatous Germ Cell Tumor Metastatic to the Neck

Coral Tieu¹, Stacie Gregory¹, Onsi Kamel² and Arun Sharma^1*

¹Division of Otolaryngology-Head and Neck Surgery, Southern Illinois University School of Medicine, USA
²Department of Pathology, HSHS St. John's Hospital, USA

^*Correspondance to: Arun Sharma 

Fulltext PDF

Abstract

Objectives: When imaging and initial cytology contradict one another, a specific diagnosis may be impossible. This places the treating physician and patient in a less than ideal situation, as they must proceed with generic or presumptive treatment for a tumor of unknown prognosis. We present a case which highlights utilizing a molecular genetics test to help clarify tumor origin through the use of specific cell markers.
Methods: Chart review was used to obtain all pertinent information regarding this 55-year-old female who presented to head and neck oncology clinic with a firm, mildly tender left level V neck mass.
Results: Excisional biopsy of the left neck mass evidenced poorly differentiated, metastatic non small cell, p16+ carcinoma on staining. PET/CT demonstrated a 1.4-cm spiculated nodule in the left upper lobe of the lung. CT-guided biopsy was negative for malignancy. The level V lymph node specimen was then sent for real-time reverse transcription polymerase chain reaction. Molecular diagnostics returned a 90% probability of a nonseminomatous germ cell tumor in this level V neck mass.
Conclusion: Proper diagnosis of the primary source of malignancy is critical not only for timely initiation of treatment and selection of appropriate therapy modalities, but also for appropriate discussions about prognosis and later monitoring of treatment response. We present a case of a mediastinal nonseminomatous germ cell tumor metastatic to the neck diagnosed by molecular diagnostics.

Keywords:

Neck mass; Extragonadal nonseminomatous germ cell tumor; Neck metastasis; Molecular diagnostics; Tumor gene expression pattern

Citation:

Tieu C, Gregory S, Kamel O, Sharma A. Mediastinal Nonseminomatous Germ Cell Tumor Metastatic to the Neck. Ann Clin Otolaryngol. 2016;1(1):1003.