DOI: 10.36347/sjmcr.2014.v02i12.013

Pages: 801-803

Although neck masses are a common presenting symptom to an otolaryngologist, we report a rare case of a 27-year-old Hispanic female who presented with a six-week history of odynophagia, fevers and a rapidly enlarging right neck mass. Fine needle aspiration revealed large histiocytes and other inflammatory cells, but no evidence of malignancy. The patient was admitted to the hospital for hydration, parenteral antibiotics and scheduled for an open biopsy. Computed tomography at admission revealed a 6x6 cm neck mass, innumerable lung nodules, and ill-defined parenchymal lesions throughout the liver, spleen, and kidneys. Soon after admission, the patient had rapid clinical deterioration with profound lactic acidosis and multiple electrolyte abnormalities, and expired just two days after admission. Her final pathology was consistent with histiocytic sarcoma and cause of death was determined to be tumor lysis syndrome resulting from massive tumor burden.