High-grade Neuroendocrine Carcinoma Presenting with Cervical Lymphadenopathy in a Teenager: A Rare Case

Background: Neuroendocrine tumors (NETs) are rare malignancies arising from neuroendocrine cells, with head and neck neuroendocrine neoplasms comprising a small percentage of cases.We present a unique case of a 19-year-old male initially suspected to have tubercular lymphadenopathy, later diagnosed with high-grade poorly differentiated neuroendocrine carcinoma (NEC). Case description:The patient presented with a persistent painful right-sided cervical swelling and discharging sinus, evolving over 8 months.Imaging revealed a mass in the pharyngeal mucosal space with metastasis to a submandibular lymph node.Surgical debulking and neck dissection were performed, confirming high-grade NEC with a Ki67 index of 75%. Conclusion:The case underscores the diagnostic challenges and management complexities of high-grade head and neck NECs.Treatment involved intensity-modulated radiation therapy with image-guided radiation therapy, targeting the primary tumor and involved lymph nodes.Prognosis for high-grade NETs is generally poor, emphasizing the need for multidisciplinary care and further research into optimal treatment strategies.Clinical significance: This case emphasizes the importance of accurate diagnosis and tailored management in rare head and neck NECs.Selecting appropriate imaging modalities, considering tumor characteristics, is crucial for guiding treatment decisions and improving patient outcomes.Collaborative efforts among multidisciplinary teams and ongoing research are essential for refining strategies for NET management.