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Clinical Problem Solving: Pathology
March 1, 2008

Pathology Quiz Case 1

Author Affiliations


Arch Otolaryngol Head Neck Surg. 2008;134(3):333. doi:

A 59-year-old woman presented with a 6-month history of a painless sensation of mild airway compression and a right-sided neck mass. Contrast-enhanced computed tomography demonstrated a well-circumscribed, right-sided, level IV nonenhancing mass (Figure 1) and a smaller mass abutting the thyroid gland (not shown). A diagnosis of branchial cleft cyst was made, and the patient underwent excision and thyroid biopsy. The pathology report identified a well-differentiated squamous cell carcinoma, and the thyroid specimen was noted to have squamous metaplasia. The patient was subsequently referred for evaluation and definitive management.

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