Abstract
Introduction: Primary neoplasia syndrome of unknown origin refers to the presence of histologically corroborated metastatic lesions whose primary origin can not be identified during the pre-treatment evaluation. In the present clinical case an extrapulmonary manifestation of undifferentiated neoplasia is presented due to its rarity and description of the diagnostic study.
Clinical Case: This is a 49-year-old man, with a right axillary mass of 1 year evolution, 30 x 20 cm, which includes the hemithorax, associated with pain 7/10, with assessment of the Eastern Cooperative Oncology Group scale (PS ECOG) of 3 in initial form. He was treated for sepsis due to infection of the tumor bed. The tomography reported the extensive tumor in the right axillary region with areas of necrosis, air bubbles, a subcentimeter nodular lesion in the apical segment of the upper lobe of the right lung and pleural effusion. The wedge biopsy reported an undifferentiated malignancy of CD-56 +, CD-79 A +, VIMENTINA +, CAM 5.2 +, CK - 20 +. It was concluded as a metastatic extrapulmonary manifestation of undifferentiated malignancy of pulmonary origin possibly of neuroendocrine origin.
Evolution: A neoadjuvant treatment with cisplatin + etoposide was established for 3 months. PS ECOG 1 scale, functional recovery of the limb, tumor reduction of 50% of tumor lesion, awaiting surgical treatment.
Conclusion: This report presents a case of metastasis syndrome of the occult primary which responds with tumor reduction to Neoadjuvant treatment. Although they are of poor prognosis in most patients, this report presents an adequate response to treatment.