Extended cervical swelling in a young patient

Introduction:

Cervical swellings in younger patients are mainly of benign origin. Differential diagnoses have to consider infectious or non- infectious lymphadenopathy, lateral neck cysts and lymphangioma. Lymphoma, lymph node metastasis and sarcoma belong to malignant causes of cervical swellings.

Casuistic:

A 23- year- old male patient initially introduced himself with an indolent supra clavicular swelling in regio III, IV, V. progressive over a cause of 12 weeks. The elevation of the right arm was limited. Clinical examination with unremarkable lab parameters showed a soft- elastic mass, which in ultrasound occurred as a primarily hypo-echoic and not completely viewable due to the large size. Computed tomography of the neck visualized a maximum expansion of 12,7 × 8,6 × 7,8 cm, resulting in the indication for surgical removal. Intra-operatively the mass extended down-rooting up to the jugular interna vein, subclavian vein as well as the plexus cervicalis with a tail up to the scapula. The surgical extirpation followed in toto. Pathology reported a lateral neck cyst of 71 g weight.

Conclusion:

Lateral neck cysts usually manifest themselves during the age of 15 and 35. Literature commonly describes an extension up to 10 cm. They are usually located between the omohyoideus muscle and the sternocleidomastoideus muscle and the mandibula. As presented a lateral neck cyst which is wide-caudally and deeply located with a tail and such an extension is a rarity and operatively challenging.

Publication History

Publication Date:
23 April 2019 (online)