The presentation of this case aims to encourage health care professionals to consider this entity as a differential diagnosis in similar cases. [revistas.unal.edu.co]

• Pain

  The first clinical manifestations of ENKL are usually local and the most common symptoms include epistaxis, mass sensation, nasal obstruction, and face pain and swelling (5); the latter two were observed in the reported patient. [revistas.unal.edu.co]

• Pharyngitis

  Physical examination on admission to the emergency department revealed periorbital edema and right hemiface edema, preserved eye movements and erythema associated with posterior pharyngeal drip. Lab test results showed pancytopenia (Table 1). [revistas.unal.edu.co]

• Ulcer

  Soft or hard palate edema may also occur, which occasionally progress to deep necrotic ulceration, as in this case. [revistas.unal.edu.co]

Blood count on admission and on the fifth day of antimicrobial treatment. [revistas.unal.edu.co]

It has an aggressive course, and its prognosis is severe, with an average survival rate between 6 and 25 months (4). [revistas.unal.edu.co]

Although the etiology of this disease is unknown, some authors consider Epstein-Barr virus as an oncogenic factor because this infection causes neoplastic transformation of natural killer (NK) cells. [revistas.unal.edu.co]

Aggressive mature natural killer cell neoplasms: from epidemiology to diagnosis. Orphanet J Rare Dis. 2013;8(1):95. https://doi.org/fvb9. 16.International Non-Hodgkin’s Lymphoma Prognostic Factors Project. [revistas.unal.edu.co]