Abstract
Extranodal natural killer/T-cell lymphoma, nasal type, is a rare and highly aggressive malignancy, often associated with rapid local destruction and a poor clinical course. We report the case of a 45-year-old man who developed rapidly progressive oronasal disease complicated by massive epistaxis, respiratory failure, and multiorgan dysfunction. His clinical course was further marked by dialysis-dependent acute kidney injury, multidrug-resistant infections, and a prolonged intensive care unit stay. Because of severe clinical instability, cyclophosphamide, doxorubicin, vincristine, and prednisone chemotherapy was selected as a feasible alternative to standard approaches but was followed by severe bone marrow aplasia. This case highlights the major challenges involved in managing this disease in critically ill patients, in whom treatment decisions must be carefully individualized according to organ failure, infectious complications, and overall clinical instability.