# Blastoid Mantle Cell Lymphoma Presenting as an Oropharyngeal Mass

## TL;DR

A rare case of blastoid mantle cell lymphoma in the throat of a 75-year-old man is reported, emphasizing personalized treatment approaches.

## Contribution

This paper presents a unique clinical case of blastoid mantle cell lymphoma with oropharyngeal presentation and discusses tailored treatment strategies.

## Key findings

- Blastoid mantle cell lymphoma presented as an oropharyngeal mass in a 75-year-old male.
- Palliative radiation led to significant tumor reduction and symptom resolution without chemoimmunotherapy.
- The case underscores the importance of personalized treatment based on patient age and comorbidities.

## Abstract

Blastoid mantle cell lymphoma (MCL) is an extremely rare neoplasm with a dismal prognosis. MCL with an initial presentation in the oral cavity has been rarely reported. This report describes a 75-year-old male who presented with an oropharyngeal mass causing dysphonia and intermittent hypoxia. A biopsy and immunophenotyping confirmed MCL, favoring the blastoid variant. Imaging showed a 4.2 cm left oropharyngeal polypoid mass with extensive lymphadenopathy. His prognosis was considered unfavorable with elevated Ki-67 index, blastoid morphology, and p53 positivity of malignant cells. There was no central nervous system involvement. He received palliative radiation, resulting in profound tumor reduction and resolution of symptoms. An intensive chemoimmunotherapy was not deemed beneficial due to age, comorbidities, absence of TP53 mutation, and a personal preference for a less aggressive treatment. This case highlights the importance of risk-adapted and personalized management approaches in a very unique presentation of blastoid MCL.