S1 E28 Case Study Series #9: Neck Mass, Sepsis, and Second Chances - A Cancer Case in Crisis

He’s just 40 years old—but walks into the ED with a rapidly worsening neck mass, a history of oropharyngeal squamous cell carcinoma, and signs of full-blown sepsis. Add to that a history of substance use, non-compliance with treatment, and a storm of social barriers, and you’ve got a case that forces you to ask: When the patient’s body and choices are both failing—how do you lead with both clinical skill and compassion?

This episode dives into a case that’s as much about medical decision-making as it is about real-life complexity.

Key Topics

• Cancer Recurrence vs. Infection:
  → How to differentiate between tumor progression and abscess in head and neck masses.

• Diagnostic Workup:
  → CT of neck, chest, abdomen/pelvis, and abdominal ultrasound: what imaging tells us—and what it doesn’t.

• 💉 Managing Sepsis in Immunocompromised Patients:
  → When aggressive fluid resuscitation, broad-spectrum antibiotics, and electrolyte management take center stage.

• Treatment Non-Compliance:
  → Understanding the implications of missed radiation and chemotherapy: tumor biology, patient autonomy, and public health risks.

• Substance Use and Social Determinants of Health:
  → Navigating pain management, discharge planning, and radiation compliance in the setting of addiction and housing instability.