Lateral Neck Mass in an Adolescent Athlete

A 17-year-old African-American athlete presented with complaints of allergies. He had a history of seasonal allergic rhinitis and otorrhea for many years, but this time it was accompanied by right-sided neck swelling. His right sternocleidomastoid was slightly enlarged, soft, nontender, and no discrete masses were palpable. He was active in shot-put and was right-handed. Following discharge with antihistamine therapy, he returned a month later with a visible enlargement of the right lateral neck and bilateral cervical adenopathy. The biopsy of the nasopharyngeal mass revealed an undifferentiated squamous nasopharyngeal carcinoma, staged at T2N3MX. Chemotherapy followed by radiation was recommended.