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SM Journal Clinical and Medical Imaging

Diagnosis of a Neck Mass in the Emergency Department

[ ISSN : 3068-000X ]

Abstract
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Received: 30-Jan-2024

Accepted: 12-Mar-2024

Published: 14-Mar-2024

Case Report | Volume 6 - Issue 1 | Article DOI :

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Schmidt S¹,²*, Lorenz KJ¹, Matthias C², Diekmeyer B3, and Müller G⁴

1Department of Otolaryngology and Plastic Surgery, Bundeswehr Central Hospital, Germany
²Department of Otolaryngology, Head and Neck Surgery, University of Mainz Medical School, Germany
3Department of Nuclear Medicine, Bundeswehr Central Hospital, Koblenz, Germany
4Department of Pathology, Bundeswehr Central Hospital, Germany

Corresponding Author:

Sandra Schmidt, Department of Otolaryngology and Head and Neck Surgery, Bundeswehr Central Hospital, Rübenacher Str. 170, D-56076 Koblenz, Germany, Tel: +49 (0) 261-28125010

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.