Rapidly Growing Neck Metastasis in Immunodeficiency
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An 80-year-old fit male with known long-standing stable chronic lymphatic leukaemia (CLL) and several stable small volume 1.5 cm neck nodes presented with a rapidly enlarging left neck mass. The mass invaded the neck skin and began to fungate. Initial Ultrasound and fine need aspiration showed a 3 cm mass, which on subsequent CT staging was shown to have grown to 10 cm in less than 3 weeks. There was no evidence of any lung metastasis. Some 2 years earlier he underwent removal of a 1 cm squamous cell carcinoma (SCC) from the right alar region of his nose. Ultrasound-guided fine needle aspiration cytology of the neck mass confirmed metastatic SCC rather than CLL. CT demonstrated a large necrotic mass with necrosis confirming rapid growth, with the tumour outstripping its blood supply. Following discussion at the head and neck MDT, he was managed surgically with a radical neck dissection including removal of the overlying skin, with a latissimus dorsi flap reconstruction followed by post-operative radiotherapy....

https://www.omicsgroup.org/journals/rapidly-growing-neck-metastasis-in-immunodeficiency-2165-7920-1000962.php?aid=89830
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