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Clinical Challenge
September 23, 2021

Rapidly Enlarging Neck Mass in a Patient With Testicular Cancer

Author Affiliations
  • 1Tufts University School of Medicine, Boston, Massachusetts
  • 2Department of Otolaryngology–Head and Neck Surgery, Tufts Medical Center, Boston, Massachusetts
JAMA Otolaryngol Head Neck Surg. 2021;147(11):1001-1002. doi:10.1001/jamaoto.2021.2420

A 40-year-old man presented with a large left neck mass in the setting of recently treated mixed nonseminomatous germ cell tumor (NSGCT) of the right testicle with metastasis to the retroperitoneal and mediastinal lymph nodes. He was treated with a right radical orchiectomy and 4 cycles of etoposide, ifosfamide, and cisplatin (VIP) chemotherapy with resulting reduction in metastatic tumor burden and normalization of α-fetoprotein and β-human chorionic gonadotropin. The patient’s neck swelling, which initially decreased in size while undergoing chemotherapy, progressively enlarged shortly after concluding treatment. He underwent magnetic resonance imaging and computed tomography of the neck that showed a clearly defined, bulky supraclavicular mass confined to left neck levels 3, 4, and 5 (Figure).

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