The patient is a 63 year-old male who was found to have a cystic mass in in the right lower neck by his local physician. The physician performed a fine needle aspiration. This produced fluid, which was cytlogically negative for malignancy. The patient was then referred to our office for further evaluation. The patient arrived to our office with the following CT of the head and neck.
| There is an oval, slightly hypodense to muscle, mass adjacent to the right jugular vein and posteromedial to the sternocleidomastoid muscle suspicious for a lymph node and, given its size, must be viewed with some suspicious for neoplasia. It measures approximately 2.1 x 1.3 cm. in two dimensions. A few other tiny lymph nodes are noted in this region. Another consideration, given its hypodense appearance and proximity to the carotid sheath, IS some type of neural tumor such as a schwannoma or neurinoma. Elsewhere, no other mass is seen. A few other very small lymph nodes not meeting pathologic size criteria are closely adjacent to the right jugular vein. This lies at about the level of the inferior portion of the hyoid bone. No other abnormality is seen. The lung apices are unremarkable. |
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Past History
The patient reports a history of hypertension, arrhythmia, and hiatal hernia. The patient denies a family history of cancer. He does not use alcohol or tobacco.
Review of Systems
A review of symptoms is non-contributory.
Physical Exam:
On clinical exam, the patient was found to have a 2cm mass in the right lower neck. There were no other significant findings.
Lab
Non-contibutory
A ultrasound guided needle biopsy was performed.