Calling All Oncologists

If you have a background in Oncology please read..

I’ll cut right to the chase as I know you have a lot of demands on your time. A family member has presented with what appears to be a very aggressive NPC. An initial pathology report came in a week ago showing the following stats:

 

Multicytokeratin: Positive

EMA: Positive

CD45: Negative

CK 5/6: Negative

EBER: Negative

P16: Positive

S100: Negative

Undifferentiated and non-keratinizing

Lymphoid Infiltrate: Positive (very dense)

Entrapped benign respiratory epithelial cells

 

Some background: The family member has never been a smoker and only rarely drinks alcohol, always in small amounts. She showed no palpable growth ~3-4 weeks ago. Two weeks ago a mass under the left ear/jaw line presented that was roughly 2 inches in length and 0.5 inch in width and was unsuccessfully biopsied in the ER. Within a couple days of this procedure her entire neck swelled up to many, many times its normal size and was then successfully biopsied. In the subsequent 4 days since that was done, the dramatic swelling has spread down her upper back, shoulder and up the side of her face/head to the extent that she requires a breathing tube and sedation. She’s currently a patient at John Muir in Walnut Creek and is as we speak being started on frontline “standard of care” Cisplatin and radiation.

 

I’m curious what your thoughts are on EBV negative NPC’s and what sort of advanced approach can be taken to both identify/characterize tumors and successfully treat them. I understand that your ability to address these questions may be limited by the fact that you are not this patient’s Dr. but anything you can provide will be very much appreciated. If you would like the pathology report or any other medical info, just say the word and I’ll send along via attached files.