Keywords
Central emergency department; Lateral neck cyst; Neck mass; Squamous cell carcinoma; p-16 positive
Abstract
Background: Patients are presenting to emergency departments with nonspecific signs and symptoms that can be associated with lifethreatening conditions.
Methods: A 61-year-old patient presented with a left-sided neck mass that had rapidly increased in size. Ultrasonography revealed a 5x4 cm mass at levels IIa-III with reduced echogenicity and posterior enhancement. There were no B symptoms or other medical conditions. Computed Tomography (CT) showed a mass suspicious of malignant lymphoma.
Results: We resected the cystic structure and took tongue base biopsies. Histology revealed a neck cyst and poorly differentiated non-keratinizing squamous cell carcinoma in the cyst wall. Positron emission tomography with CT showed a mild elevation in glucose metabolism. There were no focal areas of residual malignancy or metastatic disease. No primary tumor was found.
Conclusion: Lesions with the morphology of a cystic mass can be malignant, especially in patients over 40 years. Cystic neck metastases are often p-16 positive.
Citation
Schmidt S, Lorenz KJ, Matthias C, Diekmeyer B, Müller G (2024) Diagnosis of a Neck Mass in the Emergency Department . SM J Clin Med Imaging 6: 4.