A 19-YEAR-OLD MAN presented with an enlarging mass in the supraclavicular area of the right side of the neck. Five months earlier, he had undergone a radical orchiectomy of his right testicle for a stage 3 carcinoma (>10 cm). His presentation at that time included evidence of metastatic disease, with multiple lung nodules, retroperitoneal lymph nodes, and a mass measuring approximately 4 cm in the right supraclavicular region. His primary tumor was a mixed germ cell neoplasm consisting of seminoma, embryonal carcinoma, teratocarcinoma, and focal choriocarcinoma. After the orchiectomy, the patient was treated with 4 cycles of chemotherapy consisting of etoposide, cisplatin, and bleomycin sulfate, and posttreatment computed tomographic scans revealed a dramatic response, with only a few, small (<1 cm) lung and retroperitoneal nodes and a right supraclavicular mass measuring approximately 1 cm remaining. The mass had slowly continued to enlarge until his current clinical presentation.
Kezirian EJ, Alsarraf R, Lykins C. Imaging Quiz Case 3. Arch Otolaryngol Head Neck Surg. 2000;126(12):1501-1505. doi: