Metastatic seminoma presenting as neck and axillary lymphadenopathy in an elderly man.
Binoy YohannanAllen Omo-OgboiJohncy John KachiraSyed H JafriPublished in: Proceedings (Baylor University. Medical Center) (2023)
A man in his 60s presented with a gradual progressive right-sided neck mass. Initial core biopsy was inconclusive and he was treated with a short course of oral prednisone for presumed sarcoidosis. Two months later, the patient developed worsening dysphagia, hoarseness of voice, dyspnea, and weight loss. Physical examination revealed bilateral cervical and right axillary lymphadenopathy. A right axillary lymph node excisional biopsy was performed and immunohistochemistry was diffusely positive for OCT4, SALL4, CD117, PLAP, confirming the diagnosis of metastatic seminoma. He received three cycles of bleomycin, etoposide, and cisplatin; bleomycin was omitted for the fourth cycle due to concern for toxicity. Restaging scans after four cycles of chemotherapy showed a favorable response to therapy. Unfortunately, the patient died from bleomycin pulmonary toxicity. This case illustrates a rare and atypical presentation of metastatic seminoma in an elderly patient.
Keyphrases
- lymph node
- case report
- ultrasound guided
- neoadjuvant chemotherapy
- fine needle aspiration
- squamous cell carcinoma
- small cell lung cancer
- sentinel lymph node
- weight loss
- pulmonary fibrosis
- oxidative stress
- multiple sclerosis
- middle aged
- pulmonary hypertension
- locally advanced
- physical activity
- computed tomography
- magnetic resonance imaging
- stem cells
- germ cell
- early stage
- bariatric surgery
- community dwelling
- skeletal muscle
- gastric bypass
- roux en y gastric bypass
- insulin resistance
- type diabetes
- adipose tissue
- body mass index
- radiation therapy
- mesenchymal stem cells
- weight gain