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Clinical Problem Solving
June 2014

Abnormal Fetal Cystic Left Neck Mass

Author Affiliations
  • 1University of Texas at Southwestern, Dallas

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JAMA Otolaryngol Head Neck Surg. 2014;140(6):573-574. doi:10.1001/jamaoto.2014.477

An abnormal fetal cystic left neck mass was found on ultrasonography at 18 weeks gestation in a young woman. Fetal magnetic resonance imaging (MRI) demonstrated a large cystic anterior neck mass (Figure, A, sagittal view, and Figure, B, axial view, on T2-weighted half-Fourier acquired single turbo spin-echo [HASTE] MRI). The tracheoesophageal displacement index (TEDI) was found to be 24 mm. The neonate did well at the cesarean delivery (scheduled owing to the mother’s previous cesarean delivery) and had initial Apgar scores of 7 (1 minute) and 9 (5 minutes). Subsequently, the infant was intubated owing to increased difficulty with milky oral secretions and respiratory distress. Examination of the infant revealed a 5-cm, soft, fluctuant, and mobile neck mass that caused the head to deviate to the right with no cutaneous involvement.

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